The Performance of Serum Biomarkers for Predicting Fibrosis in Patients with Chronic Viral Hepatitis

• Published in: The Korean journal of gastroenterology Vol. 69; no. 5; pp. 298 - 307
• Main Authors: Bang, Chang Seok, Kang, Ha Yan, Choi, Gyu Ho, Kim, Suk Bae, Lee, Wonae, Song, Il Han
• Format: Journal Article
• Language: English
• Published: Korea (South) Jin Publishing & Printing Co 25.05.2017; 대한소화기학회
• Subjects: Adult; Alanine Transaminase - blood; Area Under Curve; Aspartate Aminotransferases - blood; Biomarkers - blood; Biopsy; Chronic hepatitis; Female; Hepatitis B, Chronic - complications; Hepatitis B, Chronic - diagnosis; Hepatitis C, Chronic - complications; Hepatitis C, Chronic - diagnosis; Humans; Liver - pathology; Liver Cirrhosis - diagnosis; Liver Cirrhosis - etiology; Liver Cirrhosis - pathology; Liver fibrosis; Male; Middle Aged; Platelet Count; Retrospective Studies; ROC Curve; Sensitivity and Specificity; Severity of Illness Index; 내과학; Biopsy; Chronic hepatitis; Liver fibrosis
• ISSN: 1598-9992; 2233-6869
• DOI: 10.4166/kjg.2017.69.5.298

The invasiveness of a liver biopsy and its inconsistent results have prompted efforts to develop noninvasive tools to evaluate the severity of chronic hepatitis. This study was intended to assess the performance of serum biomarkers for predicting liver fibrosis in patients with chronic viral hepatitis. A total of 302 patients with chronic hepatitis B or C, who had undergone liver biopsy, were retrospectively enrolled. We investigated the diagnostic accuracy of several clinical factors for predicting advanced fibrosis (F≥3). The study population included 227 patients with chronic hepatitis B, 73 patients with chronic hepatitis C, and 2 patients with co-infection (hepatitis B and C). Histological cirrhosis was identified in 16.2% of the study population. The grade of porto-periportal activity was more correlated with the stage of chronic hepatitis compared with that of lobular activity (r=0.640 vs. r=0.171). Fibrosis stage was correlated with platelet count (r=-0.520), aspartate aminotransferase to platelet ratio index (APRI) (r=0.390), prothrombin time (r=0.376), and albumin (r=-0.357). For the diagnosis of advanced fibrosis, platelet count and APRI were the most predictive variables (AUROC=0.752, and 0.713, respectively). In a hepatitis B endemic region, platelet count and APRI could be considered as reliable non-invasive markers for predicting fibrosis of chronic viral hepatitis. However, it is necessary to validate the diagnostic accuracy of these markers in another population.