Predictive ability of non-invasive scores to measure the National Health System’s histologic active disease cutoffs triggering treatment chronic hepatitis B
Makaleler > Tam Makale · 2016
Yazarlar: Şebnem Çalık, Evren Vecdi Genç, Alpay Arı, Hatice Uluer
The Journal of Tepecik Education and Research Hospital, Uluslararası, 2016
Özet
Objective: In Turkey chronic hepatitis B therapy can be initiated only in the presence of hepatic inflammation score equal or above 6/18 and/or fibrosis score equal or above 2/6 based on National Health Systems histologic active disease cutoffs (HADc determined by histologic examintion of liver biopsy specimens.Non-invasive hepatic scoring system may be useful to predict HAD.The aim of this study was to evaluate the predictive ability of non-invasive scores to foresee HAD for the treatment of patients with chronic hepatitis B (CHB).Method: 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 for the predictive ability to foresee cut-off values of HAD.Results: Hepatic inflamation and/or fibrosis higher than HAD cut-off values were detected in 83 patients (63%).The areas under the curve (AUCs) values of noninvasive test data used to predict HAD were statistically significant for FIB4 index (0.66),APRI (0.75), 0.73 for the HBV DNA level (0.73) and alanine aminotransferase (ALT ;0.68) as indicated in parentheses (for all p <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 of 0.5, the specificity and positive predictive value were 89.8 and 91.2%, respectively.Fifty-two (91.2%) patients out of 57 with APRI scores above 0.5 had higher HADc values above the cut-off value (as assessed by liver biopsy) in 52 (91.2%). Conclusions:The APRI score may be a useful noninvasive marker predicting National Health System HADc for treatment of CHB patients.