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Submitted: 08 Apr 2022
Accepted: 01 Jun 2022
ePublished: 06 Jun 2022
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Immunopathol Persa. 2023;9(1): e32404.
doi: 10.34172/ipp.2022.32404
  Abstract View: 193
  PDF Download: 128

Original

Comparison of invasive and non-invasive methods for assessment of liver fibrosis in patients with chronic hepatitis B and hepatitis C virus infections

Mohammad Mahdi Majzoobi 1,2 ORCID logo, Behnoosh Heidari 3 ORCID logo, Fariba Keramat 1,2, Jalal Poorolajal 4 ORCID logo, Hamid Reza Ghasemi Basir 5 ORCID logo, Ali Reza Soltanian 6 ORCID logo, Peyman Eini 1,2* ORCID logo

1 Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
2 Department of Infectious Diseases, Sina Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
3 Infectious Diseases Specialist, Homozgan University of Medical Sciences, Bandar Abbas, Iran
4 Research Center for Health Sciences and Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
5 Department of Pathology, Sina Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
6 Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
*Corresponding Author: Correspondence to Peyman Eini, Email: , Email: eini@umsha.ac.ir

Abstract

Introduction: Different methods are employed to determine the severity of chronic viral hepatitis and liver fibrosis Objectives: This study was conducted to compare invasive and non-invasive tests for assessment of liver fibrosis in the patients with chronic hepatitis B and C.

Patients and Methods: In this study, the results of liver biopsy based on the METAVIR scoring system were compared with biomarkers, including fibrosis-4 (FIB-4) and aspartate aminotransferase-to-platelet ratio index (APRI) for identifying liver fibrosis.

Results: Out of 194 patients, 63 and 131 patients had hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, respectively. There was a significant difference between patients with METAVIR stages 0-1 and patients with METAVIR stages 2-3, based on the FIB-4, aspartate aminotransferase (AST) to platelet ratio index (APRI) and the mean prothrombin time (PT), international normalized ratio (INR), platelet (PLT), alanine transaminase (ALT) and AST. A correlation was found between the FIB-4 and APRI indices and the METAVIR score of patients with hepatitis. The FIB-4 index, with a cut-off value <1.1 for detecting liver fibrosis in patients with HBV infection, showed sensitivity of 83.3%, specificity of 64.7%. Further, a positive predictive value (PPV) of 35.7%, and a negative predictive value (NPV) of 94.3% was detected. On the other hand, the APRI index, with a cut-off value <0.73, showed 59% sensitivity, 76.5% specificity, PPV of 33.3% and NPV of 86.7%. The FIB-4 index, with a cut-off value <1.47 for detecting liver fibrosis in patients with HCV infection, showed 73.7% sensitivity, 73.2% specificity, PPV of 31.8%, and NPV of 94.3%. Additionally, the APRI index, with a cut-off value <1.7, showed 42.1% sensitivity, 97.3% specificity, PPV of 72.7% and NPV of 90.8%.

Conclusion: According to the results, in patients with chronic hepatitis, the severity of liver fibrosis increased with an increase in the APRI and FIB-4 indices. Therefore, these two indices can replace biopsy under certain circumstances.


Citation: Majzoobi M, Heidari B, Keramat F, Poorolajal J, Ghasemi Basir H, Soltanian A, Eini P. Comparison of invasive and non-invasive methods for assessment of liver fibrosis in patients with chronic hepatitis B and hepatitis C virus infections. Immunopathol Persa. 2023;9(1):e32404. DOI:10.34172/ ipp.2022.32404.
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