Title |
Comparison of noninvasive models of fibrosis in chronic hepatitis B
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Published in |
Hepatology International, July 2011
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DOI | 10.1007/s12072-011-9296-5 |
Pubmed ID | |
Authors |
S. C. Raftopoulos, J. George, M. Bourliere, E. Rossi, W. B. de Boer, G. P. Jeffrey, M. Bulsara, D. J. Speers, G. MacQuillan, H. L. I. Ching, N. Kontorinis, W. Cheng, J. Flexman, S. Fermoyle, P. Rigby, L. Walsh, D. McLeod, L. A. Adams |
Abstract |
BACKGROUND AND GOALS: Liver fibrosis influences treatment and surveillance strategies in chronic hepatitis B (CHB). This multicenter study aimed to examine the accuracy of serum fibrosis models in CHB patients including those with low alanine aminotransferase (ALT) levels and serially in those undergoing treatment. METHOD: We examined noninvasive fibrosis models [Hepascore, Fibrotest, APRI, hepatitis e antigen (HBeAg)-positive and -negative models] in 179 CHB patients who underwent liver biopsy and fibrosis assessment by METAVIR and image morphometry. Serial Hepascore measurements were assessed in 40 subjects for up to 8.7 years. RESULTS: Hepascore was more accurate than Fibrotest [area under the curve (AUC) 0.83 vs. 0.72, P = 0.05] and HBeAg-positive model (AUC 0.83 vs. 72, P = 0.03) for significant fibrosis but was not significantly different to APRI or HBeAg-negative scores. Fibrosis area assessed by morphometry was correlated with Hepascore (r = 0.603, P < 0.001), Fibrotest (r = 0.392, P = 0.03), and HBeAg-positive (r = 0.492, P = 0.001) scores only. Among 73 patients with an ALT <60 IU/L, noninvasive models were useful to predict fibrosis (PPV 80-90%) or exclude significant fibrosis (NPV 79-100%). Hepascore increased significantly among patients monitored without treatment and reduced among patients undergoing therapy (0.05/year ± 0.03 vs. -0.04/year ± 0.02, P = 0.007). CONCLUSIONS: Serum fibrosis models are predictive of fibrosis in CHB and assist in identifying subjects with low-normal ALT levels for treatment. |
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Geographical breakdown
Country | Count | As % |
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Unknown | 14 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Other | 2 | 14% |
Researcher | 2 | 14% |
Student > Bachelor | 1 | 7% |
Professor | 1 | 7% |
Student > Doctoral Student | 1 | 7% |
Other | 4 | 29% |
Unknown | 3 | 21% |
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Medicine and Dentistry | 5 | 36% |
Nursing and Health Professions | 1 | 7% |
Engineering | 1 | 7% |
Unknown | 7 | 50% |