The accuracy of the FIB-4 index for the diagnosis of mild fibrosis in chronic hepatitis B.
BACKGROUND
The Fib-4 index is a simple and inexpensive biomarker to delineate liver fibrosis in chronic hepatitis C.


OBJECTIVE
To assess the accuracy of the FIB-4 index in chronic hepatitis B.


METHODS
We compared the FIB-4 index with 138 synchronous liver biopsies and with 372 synchronous FibroTest performed either in France or in an endemic area (Mayotte, an overseas collectivity of France).


RESULTS
The FIB-4 index allowed the correct identification of patients with nil-to-moderate fibrosis with an area under the receiving operating characteristic curve of 0.81 (P < 0.001), increasing as a function of the length of the liver biopsy (up to 0.94 for liver biopsies >or=20 mm). A cut-off value <or=1.45 differentiated moderate fibrosis from severe fibrosis with a negative predictive value of 86%, a sensitivity of 71.1% and a specificity of 73.1%. Beyond 1.45, the FIB-4 index was not informative. The FIB-4 index was more precise than the AST-to-platelet ratio index and correlated with the FibroTest in 89% of the cases (kappa = 0.27, P < 0.001) to exclude severe fibrosis.


CONCLUSIONS
The FIB-4 index is a simple, accurate and inexpensive method to exclude significant liver fibrosis in chronic hepatitis B, a major advantage in HBV-endemic developing countries.
Mallet
V
V
Université Paris Descartes, Paris, France. vincent.mallet@cch.aphp.fr
Dhalluin-Venier
V
V
Roussin
C
C
Bourliere
M
M
Pettinelli
M E
ME
Giry
C
C
Vallet-Pichard
A
A
Fontaine
H
H
Pol
S
S
D000328:Adult; D000410:Alanine Transaminase; D001219:Aspartate Aminotransferases; D015415:Biomarkers; D017507:Comoros; D005260:Female; D005602:France; D019694:Hepatitis B, Chronic / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D012372:ROC Curve
D015415:Biomarkers; D012367:RNA, Viral; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase