Dr Sonja Lang and colleagues analyzed the diagnostic performance and clinical utility of simple noninvasive tests for the detection of advanced fibrosis in patients with chronic hepatitis B infection seen at a tertiary referral center in Germany.
The team retrospectively analyzed 239 adult chronic hepatitis B patients with available liver biopsies.
Patient demographics, hepatitis B markers, antiviral treatment, laboratory parameters, results from liver imaging, and histology were recorded.
|Patients with advanced fibrosis on biopsy were misclassified as having mild fibrosis in 35% to 82% of cases|
|European Journal of Gastroenterology & Hepatology|
The sensitivity, specificity, and positive and negative predictive values were determined along with the area under receiver operating characteristic curves (AUROC) using published formulas and cut-off values for fibrosis index based on the 4 factors, aspartate aminotransferase–alanine aminotransferase ratio index, aspartate aminotransferase-to-platelet ratio index, and age–platelet index.
The median documented duration of chronic hepatitis B infection was 31 months.
The researchers found that 86% of the patients were Caucasian, and 71% were men.
The team noted that the AUROCs for the detection of advanced fibrosis were 0.75, 0.72, 0.48, and 0.73 for fibrosis index based on the the 4 factors, APRI, AAR, and age–platelet index, respectively.
Patients with advanced fibrosis on biopsy were misclassified as having mild fibrosis in 35% to 82% of cases.
Dr Lang's team comments, "Because of their moderate test performance, and their high misclassification rate, we could not confirm a reliable clinical utility for the analyzed noninvasive fibrosis scoring systems for the prediction of advanced fibrosis in mostly Caucasian chronic hepatitis B patients."