title: Non-invasive histologic markers of liver disease in patients with chronic hepatitis B.
abstract: BACKGROUND
  An exact histologic staging of liver fibrosis is essential for identifying the best therapeutic strategy and determining the disease prognosis in patients with chronic hepatitis B (CHB). While liver biopsy has a vital role in the management of liver diseases, it also sustains some limitations hampering its widespread use.
  
  
  OBJECTIVE
  In this study, we evaluated and compared several available indices of the severity of liver diseases in patients with hepatitis.
  
  
  METHODS
  EXCLUSION CRITERIA WERE AS FOLLOWS: decompensated liver disease, alcoholic liver disease or alcohol intake of 40 g or more per week; co-infection with human immunodeficiency virus, hepatitis C virus, or hepatitis D virus.
  
  
  RESULTS
  Results showed that AST to platelet ratio index (APRI) (odds ratio = 2.35, P = 0.01) and age (odds ratio = 1.04, P = 0.007) were independently predictive of the presence of significant liver necrosis and inflammation. On the other hand, AARPRI (odds ratio = 3.8, P = 0.07), age (odds ratio = 1.04, P = 0.02), and ALT levels (odds ratio = 1.01, P = 0.007) were predictive of a significant liver fibrosis. Further analysis with receiver-operating curve showed that none of these predictors had a fair diagnostic value (area under the curve < 70).
  
  
  CONCLUSIONS
  The APRI had the highest sensitivity and specificity (64% and 71%, respectively) for prediction of the presence of liver disease. We suggest that APRI may be applicable for the detection of a severe liver disease.
authors.affiliation: Clinical Research and Development Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Simin Dokht
authors.initials: SD
authors.lastname: Shoaei
authors.affiliation: Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Shahnaz
authors.initials: S
authors.lastname: Sali
authors.affiliation: Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Karamipour
authors.affiliation: Physiology Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Esmail
authors.initials: E
authors.lastname: Riahi
keywords: Chronic Hepatitis B; Liver Cirrhosis; Liver Disease