Evaluation of Non-invasive Diagnostic Methods as Indicators of Fibrosis in Patients with Chronic Hepatitis B

Introduction: Liver biopsy is recommended before the commencement of antiviral treatment for patients with chronic hepatitis B (CHB). Although liver biopsy is the gold standard procedure, many noninvasive tests have been established for the determining of liver damage. The aim of this study was to evaluate the efficacy of several indirect markers of liver fibrosis (APRI, AP, FIB-4, and AST /ALT ratio) in patients with CHB. Materials and Methods: In total, 91 patients with chronic hepatitis B were included into the study. Then patients with CHB infection were divided as mild and advanced fibrosis, and these two groups were compared. Results: Mean age of the patients was 39.5 +/- 14.9 years. The areas under receiver operating characteristic curve in the prediction of significant fibrosis were 0.756, 0.849, 0.742 and 0.825 for APRI, FIB-4, AST/ALT ratio, and AP index, and FIB-4 score and AP index were the best indicators for the detection of advanced fibrosis. For FIB-4 and AP index, the cut-off values for the prediction of advanced fibrosis were >= 1.05 and >= 3.5 with a sensitivity and specificity of 87%, 74% and 62%, 75% respectively. Conclusion: According to the results of our study, FIB-4 score and AP index may be considered as good indicators for predicting advanced fibrosis in CHB subjects.