title: APRI and FIB-4 are good predictors of the stage of liver fibrosis in chronic hepatitis B: the Chronic Hepatitis Cohort Study (CHeCS).
abstract: We aim to determine the predictive ability of APRI, FIB-4 and AST/ALT ratio for staging of liver fibrosis and to differentiate significant fibrosis (F2-F4) from none to minimal fibrosis (F0-F1) in chronic hepatitis B (CHB). Liver biopsy results were mapped to an F0-4 equivalent fibrosis stage. Mean APRI and FIB-4 scores were significantly higher for each successive fibrosis level from F1 to F4 (P < 0.05). Based on optimized cut-offs, the AUROCs in distinguishing F2-F4 from F0 to F1 were 0.81 (0.76-0.87) for APRI, 0.81 (0.75-0.86) for FIB-4 and 0.56 (0.49-0.64) for AST/ALT ratio. APRI and FIB-4 distinguished F2-F4 from F0 to F1 with good sensitivity and specificity and can be useful for treatment decisions and monitoring progression of fibrosis.
authors.affiliation: Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: E
authors.initials: E
authors.lastname: Teshale
authors.forename: M
authors.initials: M
authors.lastname: Lu
authors.forename: L B
authors.initials: LB
authors.lastname: Rupp
authors.forename: S D
authors.initials: SD
authors.lastname: Holmberg
authors.forename: A C
authors.initials: AC
authors.lastname: Moorman
authors.forename: P
authors.initials: P
authors.lastname: Spradling
authors.forename: V
authors.initials: V
authors.lastname: Vijayadeva
authors.forename: J A
authors.initials: JA
authors.lastname: Boscarino
authors.forename: M A
authors.initials: MA
authors.lastname: Schmidt
authors.forename: S C
authors.initials: SC
authors.lastname: Gordon
mesh_terms: D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: APRI; AST/ALT ratio; FIB-4; chronic hepatitis B; liver fibrosis