Diagnostic accuracy of serum biochemical fibrosis markers in children with chronic hepatitis B evaluated by receiver operating characteristics analysis.
OBJECTIVE
To investigate the diagnostic accuracy of potent serum biochemical fibrosis markers in children with chronic hepatitis B evaluated by receiver operating characteristics (ROC) analysis.


METHODS
We determined the serum level of apolipoprotein A-I (APO A-I), haptoglobin (HPT) and a-2 macroglobulin (A2M) with an automatic nephelometer in 63 children (age range 4-17 years, mean 10 years) with biopsy-verified chronic HBeAg-positive hepatitis B. Fibrosis stage and inflammation grade were assessed in a blinded fashion according to Batts and Ludwig. We defined mild liver fibrosis as a score < or =2 and advanced fibrosis as a score equal to 3. ROC analysis was used to calculate the power of the assays to detect advanced liver fibrosis (AccuROC, Canada).


RESULTS
Serum concentrations of APO A-I, HPT and A2M were not significantly different in patients with chronic hepatitis B compared to controls. However, APO A-I level of 1.19 ng/L had a sensitivity of 85.7% and a specificity of 60.7% (AUC = 0.7117, P = 0.035) to predict advanced fibrosis. All other serum biochemical markers and their combination did not allow a useful prediction. None of these markers was a good predictor of histologic inflammation.


CONCLUSIONS
Apolipoprotein A-I may be a suitable serum marker to predict advanced liver fibrosis in children with chronic hepatitis B.
Lebensztejn
Dariusz Marek
DM
3 rd Department of Pediatrics, Medical University of Bialystok, 17 Waszyngtona Str., 15-274 Bialystok, Poland. dariuszmar. 8810735@pharmanet.com.pl
Skiba
Elzbieta
E
Tobolczyk
Jolanta
J
Sobaniec-Lotowska
Maria Elzbieta
ME
Kaczmarski
Maciej
M
D000293:Adolescent; D016632:Apolipoprotein A-I / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006242:Haptoglobins / Q000378:metabolism; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012372:ROC Curve; D000511:alpha-Macroglobulins / Q000378:metabolism
D016632:Apolipoprotein A-I; D015415:Biomarkers; D006242:Haptoglobins; D000511:alpha-Macroglobulins