scholarly journals A Generic Nomogram Predicting the Stage of Liver Fibrosis Based on Serum Biochemical Indicators Among Chronic Hepatitis B Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Xueying Xu ◽  
Wusheng Wang ◽  
Qimeng Zhang ◽  
Weijie Cai ◽  
Mingcheng Wu ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Liver Biopsy ◽  
Chronic Hepatitis B ◽  
Multinomial Model ◽  
Training Set ◽  
Biochemical Indicators ◽  
Validation Set ◽  
Severe Fibrosis

Introduction: Liver fibrosis staging is of great importance for reducing unnecessary injuries and prompting treatment in chronic viral hepatitis B patients. Liver biopsy is not suitable to act a screening method although it is a gold standard because of various shortcomings. This study aimed to establish a predictive nomogram as a convenient tool to effectively identify potential patients with different stages of liver fibrosis for patients with chronic hepatitis B.Methods: A nomogram for multinomial model was developed in a training set to calculate the probability for each stage of fibrosis and tested in a validation set. Fibrosis stages were subgrouped as followed: severe fibrosis/cirrhosis (F3–F4), moderate fibrosis (F2), and nil-mild fibrosis (F0–F1). The indicators were demographic characteristics and biochemical indicators of patients. Continuous indicators were divided into several groups according to the optimal candidate value generated by the decision tree.Results: This study recruited 964 HBV patients undergoing percutaneous liver biopsy. The multinomial model with 10 indicators was transformed into the final nomogram. The calibration plot showed a good agreement between nomogram-predicted and observed probability of different fibrosis stages. Areas under the receiver operating characteristics (AUROCs) for severe fibrosis/cirrhosis were 0.809 for training set and 0.879 for validation set. For moderate fibrosis, the AUROCs were 0.75 and 0.781. For nil-mild fibrosis, the AUROCs were 0.792 and 0.843. All the results above showed great predictive performance in predicting the stage of fibrosis by our nomogram.Conclusion: Our model demonstrated good discrimination and extensibility in internal and external validation. The proposed nomogram in this study resulted in great reliability and it can be widely used as a convenient and efficient way.

scholarly journals The Role of Liver Fibrosis Assessment in the Management of Patients with Chronic Hepatitis B Infection: Lessons Learned from a Single Centre Experience

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Raza Malik ◽  
Patrick Kennedy ◽  
Deepak Suri ◽  
Ashley Brown ◽  
Rob Goldin ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Liver Biopsy ◽  
Chronic Hepatitis B ◽  
Hbv Dna ◽  
Hepatitis B Infection ◽  
Chronic Hepatitis B Infection ◽  
Normal Alt ◽  
Severe Fibrosis

Background & Aims. Assess the clinical utility of the Prati criteria and normal ALT (<40 IU/L) in a cohort of patients with chronic hepatitis B infection (CHB). Methods. Serology, radiology, and histology were obtained in 140 patients with CHB. Results. HBeAg+ group: 7 patients (7/56−12% HBeAg+ group) misclassified as “immunotolerant”, with HBV DNA > 6 log copies/ml and normal ALT, who in fact had moderate/severe fibrosis on liver biopsy. HBeAg− group: 10 patients with normal ALT and moderate/severe fibrosis on liver biopsy; 4 of these patients had >3 log copies/ml HBV DNA levels and 6 patients misclassified as “inactive carriers” with negative HBV DNA levels normal ALT and moderate/severe fibrosis (6/84−7% HBeAg− group). Two male HBeAg+ and three male HBeAg- patients with ALT between 20 and 30 IU/L and moderate/severe fibrosis on liver biopsy would have been further mischaracterised using the Prati criteria for normal ALT. Age and ethnic group were more important predictors of moderate/severe fibrosis in multivariate analysis. Conclusion. HBeAg status, age, ethnic origin with longitudinal assessment of LFTs and viral load should be studied in patients with “normal ALT” at the upper end of normal range (ALT 20–40 IU/L) to appropriately classify patients and identify patients for liver fibrosis assessment to inform treatment decisions.

STUDY THE BIOCHEMICAL, VIRAL AND LIVER FIBROSIS RESPONSES IN PATIENTS WITH CHRONIC HEPATITIS B AFTER 12 MONTH-TREATMENT BY ENTECAVIR

2015 ◽  
pp. 36-43
Author(s):  
Viet Thinh Nguyen ◽  
Van Huy Tran
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Liver Biopsy ◽  
Key Words ◽  
Chronic Hepatitis B ◽  
Hbv Dna ◽  
Controlled Study ◽  
Viral Responses

Introduction: Assessing the histological character liver fibrosis by transient hepatic elastography (TE) by Fibroscan has several advantages when compared with liver biopsy and can indicate repeatedly; therefore it can help us to follow up the treatment of chronic hepatitis B. This study is aimed at assessing the biochemical, viral and liver elasticity responses in patients with chronic hepatitis B after 12 months of entecavir treatment. Methods: Prospective, open, non-controlled study. 75 patients over 16 years old were diagnosed with chronic hepatitis B and treated with Entecavir 0.5 mg orally 2 hours after meal during 12 months. Using Fibroscan to assess the liver fibrosis according to the METAVIR classification. Results: ALT decreased rapidly after 3 months of treatment. There were differences in ALT at baseline, compared with ALT at 3 months, 6 months and 12 months (p < 0.05). HBV-DNA responsed below detection thredsold is 32%, 54.7% and 84% after 3, 6, 12 months of treatment, respectively (p<0.05). The change in the Fibroscan value > 1KPa at 6 months was 53.3% after treatment, and this was lower than this proportion at 12 months (61.3%) (p<0.001). Conclusion: Fibroscan may be used as a mean to monitor the responses to HBV treatment besides the biochemical and viral responses. Key words: Chronic B hepatitis, Entecavir, Elastography, Fibroscan

scholarly journals A Novel Prediction Model for Significant Liver Fibrosis in Patients with Chronic Hepatitis B

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Yaqiong Chen ◽  
Jiao Gong ◽  
Wenying Zhou ◽  
Yusheng Jie ◽  
Zhaoxia Li ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Liver Cancer ◽  
Hepatitis B ◽  
Liver Biopsy ◽  
Chronic Hepatitis B ◽  
Calibration Curve ◽  
Predictive Accuracy ◽  
Net Benefits ◽  
Significant Liver Fibrosis

Background. Preventing liver fibrosis from progressing to cirrhosis and even liver cancer is a key step in the treatment of chronic hepatitis B (CHB). This study is aimed at constructing and validating a new nomogram for predicting significant liver fibrosis (S≥2) in CHB patients. Methods. The nomogram was based on a retrospective study of 252 CHB patients. The predictive accuracy and discriminative ability of the nomogram were evaluated by the area under receiver operating characteristic curve (AUROC), decision curves, and calibration curve compared with the fibrosis 4 score (FIB-4) and aspartate aminotransferase-to-platelet ratio index (APRI). The results were validated using bootstrap resampling and an external set of 168 CHB patients. Results. A total of 420 CHB patients were enrolled based on liver biopsy results. Independent factors predicting significant liver fibrosis were laminin (LN), procollagen type III N-terminal peptide (PIIINP), and blood platelet count (PLT) in a multivariate analysis, and these factors were selected to construct the nomogram. The calibration curve for the probability of significant liver fibrosis showed optimal agreement between the prediction from the nomogram and actual observation. The prediction from the nomogram was more consistent with the results of liver biopsy than FIB-4 and APRI. The AUROC of the nomogram was higher than that of FIB-4 and APRI for predicting significant liver fibrosis. These results were confirmed in the validation set. Furthermore, the decision curve analysis suggested that the most net benefits were provided by the nomogram. Conclusions. We found the proposed nomogram resulted in a more accurate prediction of significant liver fibrosis in CHB patients and could provide the most net benefits. We recommend this noninvasive assessment for patients with liver fibrosis to avoid the risk of liver biopsy and earlier intervention to prevent the development of cirrhosis or liver cancer.

scholarly journals A209 NON-INVASIVE ASSESSMENT OF LIVER FIBROSIS USING APRI, FIB-4, AND TRANSIENT ELASTOGRAPHY IN CHRONIC HEPATITIS B PATIENTS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 239-240
Author(s):  
D H Little ◽  
S Fischer ◽  
S K Fung
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Liver Biopsy ◽  
Chronic Hepatitis B ◽  
Transient Elastography ◽  
Hbv Dna ◽  
Advanced Fibrosis ◽  
Predictive Values ◽  
Non Invasive

Abstract Background Accurate assessment of liver fibrosis is important to identify patients with chronic hepatitis B (CHB) who require antiviral therapy. As liver biopsy is invasive and costly, non-invasive tests of liver fibrosis are increasingly being used. Aims We aimed to evaluate the performance of the aspartate aminotransferase-to-platelet ratio index (APRI), Fibrosis 4 index (FIB-4), and transient elastography (TE) in predicting fibrosis in patients with CHB. Methods We retrospectively analyzed a prospectively enrolled cohort of consecutive adults with CHB who underwent liver biopsy for routine clinical indications (ALT &gt; ULN and HBV DNA &gt; 2,000 IU/ml) from January 2018 to December 2019. Demographic information, routine biochemistry, HBV serology including HBV DNA, abdominal ultrasound, fibrosis stage by liver biopsy and TE data were collected. Positive predictive values (PPV) and negative predictive values (NPV) were calculated using published cut-off values with liver biopsy as the reference standard. Results Fifty-five patients of Asian ethnicity (mean age 46 years, 65% male) were included. Most patients were HBeAg-negative (67%) and treatment-naïve (80%). Eleven (20%) patients had advanced fibrosis (F3-F4 METAVIR) and 4 (7%) patients had cirrhosis (F4). APRI &lt;0.50 had a NPV of 73% for significant fibrosis (F2-F4) and APRI &gt;1.50 had a PPV of 33% for significant. All 4 patients with cirrhosis were misclassified as having no cirrhosis with an APRI &lt;1. FIB-4 &lt;1.45 had a NPV of 90% for advanced fibrosis (F3-F4). No patient, including 11 patients with advanced fibrosis, had a FIB-4 above the cut-off value to detect advanced fibrosis (&gt;3.25). TE data was available for 38 patients. TE &lt;7.25 kPa had a NPV of 78% for significant fibrosis and TE &gt;12.4 kPa had a PPV of 50% for cirrhosis. Conclusions In Asian patients with CHB and a low prevalence of advanced fibrosis or cirrhosis, APRI, FIB-4, and TE performed well in excluding those with advanced fibrosis but were unable to accurately identify those with significant/advanced fibrosis and cirrhosis. Further studies with larger numbers of CHB patients are needed to confirm our results. Funding Agencies None

scholarly journals 728 DISCORDANCE BETWEEN LIVER BIOPSY AND FIBROTEST IN ASSESSING LIVER FIBROSIS IN CHRONIC HEPATITIS B

2013 ◽  
Vol 58 ◽  
pp. S295
Author(s):  
M.S. Park ◽  
B.K. Kim ◽  
J.Y. Cheong ◽  
D.J. Kim ◽  
J.Y. Park ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Liver Biopsy ◽  
Chronic Hepatitis B

scholarly journals Discordance between Liver Biopsy and FibroTest in Assessing Liver Fibrosis in Chronic Hepatitis B

PLoS ONE ◽  
2013 ◽  
Vol 8 (2) ◽  
pp. e55759 ◽  
Author(s):  
Mi Sung Park ◽  
Beom Kyung Kim ◽  
Jae Yoeun Cheong ◽  
Dong Joon Kim ◽  
Jun Yong Park ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Liver Biopsy ◽  
Chronic Hepatitis B

scholarly journals Assessment of Liver Fibrosis by Transient Elastography in Children with Chronic Hepatitis B Virus Infection

2021 ◽  
Author(s):  
Zhiqiang Xu ◽  
Jinfang Zhao ◽  
Jiaye Liu ◽  
Yi Dong ◽  
Fuchuan Wang ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Liver Biopsy ◽  
Chronic Hepatitis B ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Activity Grade ◽  
Advanced Fibrosis ◽  
Chronic Hepatitis B Virus

Abstract Background: This study aimed to investigate the effectiveness of transient elastography (TE) by comparing liver biopsies to assess liver fibrosis in children with chronic hepatitis B (CHB). Methods: A total of 157 CHB children aged 0 - 6 years in China were enrolled in this single-center prospective study. All patients underwent liver stiffness measurement (LSM) by TE and liver biopsy at an interval of less than a week. Results: LSM, aspartate aminotransferase (AST)-platelet ratio index (APRI), and fibrosis-4 score (FIB-4) positively correlated with activity grade and fibrosis stage in children with CHB. The area under receiver operating characteristic curves (AUCs) of LSM for identifying significant (F ≥ 2) and advanced fibrosis (F ≥ 3) were 0.732 and 0.94, the cut-off values were 5.6 kPa and 6.9 kPa, specificity of 75.7% and 91.5%, and sensitivity of 67.4% and 81.3%, respectively. Compared to LSM, the overall diagnostic performance of APRI and FIB-4 for significant and advanced fibrosis was suboptimal with low AUCs and sensitivity. Since LSM, platelet, and Log10HBsAg were independent factors with the fibrosis stages (F < 2 and F ≥ 2) on the liver biopsy, the LPS index was formulated to predict F ≥ 2 by combining LSM, platelet, and Log10HBsAg. The AUC of LPS for F ≥ 2 was increased to 0.792, which was higher than that of LSM (0.732, p < 0.05), with an improved sensitivity (76.6% vs 67.4%).Conclusions: TE represents a promising technology for the diagnosis of advanced fibrosis in CHB children aged 0 - 6 years.

Sign in / Sign up

Export Citation Format

Share Document