Noninvasive Tests for Fibrosis Predict 5-Year Mortality and Hepatocellular Carcinoma in Patients With Chronic Hepatitis B.
To evaluate the degree of liver fibrosis as a predictor of mortality and hepatocellular carcinoma (HCC) development among patients with chronic hepatitis B.



The level of fibrosis predicts mortality and liver-related complications.



A total of 542 patients over 18 years old with chronic hepatitis B who visited the Konkuk University Hospital between the years 2005 and 2006 were enrolled. We performed noninvasive tests of fibrosis (APRI, FIB-4) and hepatitis B virus (HBV) DNA levels. The data on mortality and newly developed HCC collected during a 5-year follow-up were analyzed.



In 5 years, 40 patients died and 68 patients developed HCC. The area under the receiver operator characteristic (AUROC) curve of APRI, FIB-4, and HBV DNA levels for mortality was 0.760, 0.789, and 0.463, with cut-off points at 0.766, 2.671, and 3.150, respectively. The AUROC curve of APRI, FIB-4, and HBV DNA levels for HCC was 0.731, 0.803, and 0.523, with cut-off points at 0.766, 2.225, and 4.245, respectively. APRI and FIB-4 were predictors of mortality and HCC development, where patients with APRI over 0.766 had a greater risk of death [odds ratio (OR)=3.214, 95% confidence interval (CI), 1.009-10.238] and HCC development (OR=4.245, 95% CI, 1.723-10.456). Patients with FIB-4>2.671 had a higher risk of death (OR=4.431, 95% CI, 1.512-12.986) and those over 2.225 had a greater risk of developing HCC (OR=3.607, 95% CI, 1.622-8.021).



APRI and FIB-4 may be more useful than HBV DNA level in predicting 5-year mortality and development of HCC.
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea.
Jeong Han
JH
Kim
Ji Wan
JW
Kim
Jung Woong
JW
Seo
Won Hyeok
WH
Choe
So Young
SY
Kwon
D000328:Adult; D019540:Area Under Curve; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology; D005260:Female; D019694:Hepatitis B, Chronic; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality* / Q000473:pathology; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D056910:Republic of Korea; D012720:Severity of Illness Index; D016019:Survival Analysis