Abstract

INTRODUCTION

In Turkey chronic hepatitis B therapy can only be started at shown hepatic inflammation equal or above 6/18 and/or fibrosis equal or above 2/6 by liver biopsy which were National Health Systems histologic active disease cutoffs (HADc). Non invasive hepatic scoring system may be useful to predict HAD. The aim of study was to evaluate the predictive ability of non-invasive scores to predict HAD for treatment of patients with chronic hepatitis B (CHB).

METHODS

In this retrospective study, we analyzed data from 132 CHB patients who had been subjected to liver biopsy. Previously described Noninvasive scoring models APRI, Hui’s model, Age/platelet ratio, Forn’s index, FIB-4 index and AST/ALT ratio were evaluated to predict HAD.

RESULTS

Eightythree of patients (%63) were determined hepatic inflamations and/or fibrosis higher than HADc. The areas under the curves (AUCs) of noninvasive test data used to predict HAD were 0.66 for the FIB4 index, 0.75 for the APRI, 0.73 for the HBV DNA level and 0.68 for the alanin aminotransferase (ALT) test; these values were statistically significant (all p values <0.05). The ability of the AST - to - platelet ratio (APRI) to predict cutoffs was greater than that of the other measures. At APRI cut off value was 0.5, the specificity and positive predictive value were 89.8% and 91.2% respectively. Of the 57 patients with APRI scores above 0.5 had higher than HADc (as assessed by liver biopsy) in 52 (91.2%).

DISCUSSION AND CONCLUSION

The APRI score may be a useful noninvasive marker predicting National Health System HADc for treatment of CHB patients.