Applicability of APRI and FIB-4 as a transition indicator of liver fibrosis in patients with chronic viral hepatitis.
APRI
FIB-4
HBV
HCV
Longitudinal change
Journal
Journal of gastroenterology
ISSN: 1435-5922
Titre abrégé: J Gastroenterol
Pays: Japan
ID NLM: 9430794
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
received:
24
12
2020
accepted:
18
03
2021
pubmed:
2
4
2021
medline:
24
11
2021
entrez:
1
4
2021
Statut:
ppublish
Résumé
The usefulness of APRI or FIB-4 is well established as a non-invasive liver fibrosis marker at a point of diagnosis in patients with chronic liver disease. However, their applicability for the monitoring of progression of liver fibrosis over time is yet to be determined. We aimed to clarify the feasibility of APRI and FIB-4 for the longitudinal evaluation of liver fibrosis in patients with chronic hepatitis B and C. This is a multi-center retrospective and prospective cohort study, enrolling 1029 patients with HCV and 384 patients with HBV who were histologically diagnosed by liver biopsy. The observation period of retrospective and prospective study was 14 and 12 years, respectively. The APRI and FIB-4 were traced back in cases of histologically diagnosed cirrhosis, and those were prospectively analyzed after biopsy in cases diagnosed as F3 of METAVIR score, respectively. The averaged APRI and FIB-4 exhibited time-dependent increase in the retrospective study of hepatitis C patients (increase by 0.09/year in APRI and 0.29/year in FIB-4). In the prospective study of untreated hepatitis C patients, such increases were 0.14/year in APRI and 0.40/year in FIB-4, respectively. Neither the average of APRI nor FIB-4 showed a specific tendency with hepatitis B patients and treatment-experienced hepatitis C patients. The APRI and FIB-4 may serve as a transition indicator of liver fibrosis in anti-viral treatment-naïve patients with chronic hepatitis C.
Sections du résumé
BACKGROUND AND AIMS
The usefulness of APRI or FIB-4 is well established as a non-invasive liver fibrosis marker at a point of diagnosis in patients with chronic liver disease. However, their applicability for the monitoring of progression of liver fibrosis over time is yet to be determined. We aimed to clarify the feasibility of APRI and FIB-4 for the longitudinal evaluation of liver fibrosis in patients with chronic hepatitis B and C.
METHODS
This is a multi-center retrospective and prospective cohort study, enrolling 1029 patients with HCV and 384 patients with HBV who were histologically diagnosed by liver biopsy. The observation period of retrospective and prospective study was 14 and 12 years, respectively. The APRI and FIB-4 were traced back in cases of histologically diagnosed cirrhosis, and those were prospectively analyzed after biopsy in cases diagnosed as F3 of METAVIR score, respectively.
RESULTS
The averaged APRI and FIB-4 exhibited time-dependent increase in the retrospective study of hepatitis C patients (increase by 0.09/year in APRI and 0.29/year in FIB-4). In the prospective study of untreated hepatitis C patients, such increases were 0.14/year in APRI and 0.40/year in FIB-4, respectively. Neither the average of APRI nor FIB-4 showed a specific tendency with hepatitis B patients and treatment-experienced hepatitis C patients.
CONCLUSION
The APRI and FIB-4 may serve as a transition indicator of liver fibrosis in anti-viral treatment-naïve patients with chronic hepatitis C.
Identifiants
pubmed: 33791882
doi: 10.1007/s00535-021-01782-3
pii: 10.1007/s00535-021-01782-3
doi:
Substances chimiques
Biomarkers, Tumor
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
470-478Références
Seto WK, Lo YR, Pawlotsky JM, et al. Chronic hepatitis B virus infection. Lancet. 2018;392:2313–24.
doi: 10.1016/S0140-6736(18)31865-8
Trivedi HD, Patwardhan VR, Malik R. Chronic hepatitis C infection—Noninvasive assessment of liver fibrosis in the era of direct acting antivirals. Dig Liver Dis. 2019;51:183–9.
doi: 10.1016/j.dld.2018.11.016
Singh S, Muir AJ, Dieterich DT, et al. American Gastroenterological Association Institute technical review on the role of elastography in chronic liver diseases. Gastroenterology. 2017;152:1544–77.
doi: 10.1053/j.gastro.2017.03.016
World Health Organization. Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection. https://www.who.int/hiv/pub/hepatitis/hepatitis-b-guidelines/en/ . Accessed 31 July 2020.
World Health Organization. Guidelines for the screening, care and treatment of persons with hepatitis C infection. https://www.who.int/hiv/pub/hepatitis/hepatitis-c-guidelines/en/ . Accessed 31 July 2020.
Terrault NA, Lok ASF, McMahon BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018;67:1560–99.
doi: 10.1002/hep.29800
AASLD-IDSA Hepatitis C Guidance Panel. Hepatitis C Guidance. Update: American Association for the Study of Liver Diseases-Infectious Diseases Society of America Recommendations for testing, managing, and treating hepatitis C virus infection. Hepatology. 2019;2020(71):686–721.
European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol. 2017;67:370–98.
doi: 10.1016/j.jhep.2017.03.021
European Association for the Study of the Liver. EASL recommendations on treatment of hepatitis C 2018. J Hepatol. 2018;69:461–511.
doi: 10.1016/j.jhep.2018.03.026
Japanese Guideline for Management of Hepatitis B ver 3.1 (written in Japanese). The Japan Society of Hepatology. 2019. https://www.jsh.or.jp/medical/guidelines/jsh_guidlines/hepatitis_b . Accessed 31 July 2020.
Japanese Guideline for Management of Hepatitis C ver 7 (written in Japanese). The Japan Society of Hepatology. 2019. http://www.jsh.or.jp/medical/guidelines/jsh_guidlines/hepatitis_c . Accessed 31 July 2020.
Papastergiou V, Tsochatzis E, Burroughs AK. Non-invasive assessment of liver fibrosis. Ann Gastroenterol. 2012;25:218–31.
pubmed: 24714123
pmcid: 3959378
Westbrook RH, Dusheiko G. Natural history of hepatitis C. J Hepatol. 2014;61:S58-68.
doi: 10.1016/j.jhep.2014.07.012
Kanda Y. Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant. 2013;48:452–8.
doi: 10.1038/bmt.2012.244
Lu M, Li J, Zhang T, Chronic hepatitis cohort study investigators, et al. Serum biomarkers indicate long-term reduction in liver fibrosis in patients with sustained virological response to treatment for HCV infection. Clin Gastroenterol Hepatol. 2016;14:1044-1055.e3.
doi: 10.1016/j.cgh.2016.01.009
Schmid P, Bregenzer A, Huber M, Swiss HIV cohort study, et al. Progression of liver fibrosis in HIV/HCV co-infection: a comparison between non-invasive assessment methods and liver biopsy. PLoS ONE. 2015;10:e0138838.
doi: 10.1371/journal.pone.0138838
Hiramatsu N, Hayashi N, Kasahara A, et al. Improvement of liver fibrosis in chronic hepatitis C patients treated with natural interferon alpha. J Hepatol. 1995;22:135–42.
doi: 10.1016/0168-8278(95)80420-X
Elsharkawy A, Alem SA, Fouad R, et al. Changes in liver stiffness measurements and fibrosis scores following sofosbuvir based treatment regimens without interferon. J Gastroenterol Hepatol. 2017;32:1624–30.
doi: 10.1111/jgh.13758
Xiao G, Yang J, Yan L. Comparison of diagnostic accuracy of aspartate aminotransferase to platelet ratio index and fibrosis-4 index for detecting liver fibrosis in adult patients with chronic hepatitis B virus infection: a systemic review and meta-analysis. Hepatology. 2015;61:292–302.
doi: 10.1002/hep.27382
Xu XY, Kong H, Song RX, et al. The effectiveness of noninvasive biomarkers to predict hepatitis B-related significant fibrosis and cirrhosis: a systematic review and meta-analysis of diagnostic test accuracy. PLoS ONE. 2014;9:e100182.
doi: 10.1371/journal.pone.0100182
Xu XY, Wang WS, Zhang QM, et al. Performance of common imaging techniques vs serum biomarkers in assessing fibrosis in patients with chronic hepatitis B: A systematic review and meta-analysis. World J Clin Cases. 2019;7:2022–37.
doi: 10.12998/wjcc.v7.i15.2022
Zhang Z, Wang G, Kang K, et al. The diagnostic accuracy and clinical utility of three noninvasive models for predicting liver fibrosis in patients with HBV infection. PLoS ONE. 2016;11:e0152757.
doi: 10.1371/journal.pone.0152757
Li Q, Ren X, Lu C, et al. Evaluation of APRI and FIB-4 for noninvasive assessment of significant fibrosis and cirrhosis in HBeAg-negative CHB patients with ALT ≤ 2 ULN: A retrospective cohort study. Medicine (Baltimore). 2017;96:e6336.
doi: 10.1097/MD.0000000000006336
Sanai FM, Farah T, Albeladi K, et al. Diminished accuracy of biomarkers of fibrosis in low replicative chronic hepatitis B. BMC Gastroenterol. 2017;17:101.
doi: 10.1186/s12876-017-0658-x
Kim WR, Berg T, Asselah T, et al. Evaluation of APRI and FIB-4 scoring systems for non-invasive assessment of hepatic fibrosis in chronic hepatitis B patients. J Hepatol. 2016;64:773–80.
doi: 10.1016/j.jhep.2015.11.012
Stasi C, Salomoni E, Arena U, et al. Non-invasive assessment of liver fibrosis in patients with HBV-related chronic liver disease undergoing antiviral treatment: a preliminary study. Eur J Pharmacol. 2017;806:105–9.
doi: 10.1016/j.ejphar.2017.03.063
Li J, Gordon SC, Rupp LB, et al. CHeCS Investigators. Long-term progression of viral load and serum markers of fibrosis among treated and untreated patients with chronic hepatitis B. J Gastroenterol Hepatol. 2017;32:1250–7.
doi: 10.1111/jgh.13667
Graf C, Mondorf A, Knop V, et al. Evaluation of point shear wave elastography using acoustic radiation force impulse imaging for longitudinal fibrosis assessment in patients with HBeAg-negative HBV infection. J Clin Med. 2019;8:2101.
doi: 10.3390/jcm8122101
Patel K, Sebastiani G. Limitations of non-invasive tests for assessment of liver fibrosis. JHEP Rep. 2020;2:100067.
doi: 10.1016/j.jhepr.2020.100067
Hagström H, Talbäck M, Andreasson A, et al. Repeated FIB-4 measurements can help identify individuals at risk of severe liver disease. J Hepatol. 2020;73:1023–9.
doi: 10.1016/j.jhep.2020.06.007