Non-invasive tests in prediction of liver fibrosis in chronic hepatitis B and comparison with post-antiviral treatment results

SummaryBackground and aimThe aim of this study was to assess and compare the performance of a series of non-invasive tests to detect fibrosis in patients with chronic hepatitis B (CHB).Patients and methodsSeventy-six patients with CHB, whose blood samples were collected and biopsies were done on the same day, were included in this study. Pre-treatment calculations of aspartate aminotransferase to platelet ratio index (APRI), Forn's index, FIB-4, S-index, Shanghai Liver Fibrosis Group's index (SLFG) and Hepascore® were done and relations with mild and advanced fibrosis and cirrhosis were assessed. Post-treatment values of APRI, Forn's index, FIB-4, S-index with oral antiviral agents were also investigated.ResultsAPRI, S-index, SLFG, FIB-4, Forn's index and Hepascore® had 0.669, 0.669, 0.739, 0.741, 0.753, 0.780; retrospectively Area Under the Receiver Operating Characteristic Curve (AUROC) for significant fibrosis. APRI, Forn's index, S-index, FIB-4, SLFG, and Hepascore® had 0.681, 0.714, 0.715, 0.738, 0.747, 0.777 retrospectively AUROC for advanced fibrosis. APRI, SLFG, FIB-4, Forn's index, S-index, and Hepascore® had 0.741, 0.742, 0.768, 0.779, 0.792, 0.824 retrospectively AUROC for cirrhosis. APRI, Forn's index, FIB-4 and S-index were significantly lower in post-treatment group compared with pre-treatment group (P-values: < 0.05, 0.001, 0.003, 0.018; respectively).ConclusionHepascore® showed the best performance to predict significant fibrosis. Our study also suggests that the use of non-invasive test to predict fibrosis in patients with CHB may reduce the need for liver biopsy and may help to monitor the efficacy of treatment.