1839
Diagnostic performance of APRI, FIB-4 and Fibroscan
for assessment of hepatic fibrosis in chronic hepatitis B
patients receiving oral antiviral therapy; 7-year real life
data
Iftihar Koksal1, Gurdal Yilmaz1, Ilknur Yavuz2,1; 1Infectious Diseases,
Black Sea Technical University Faculty of Medicine, Trabzon,
Turkey; 2Infectious Diseases, Giresun University Medical
Faculty, Trabzon, Turkey
Background: Regression of advanced liver fibrosis is one of the
new concepts in hepatology. The effect of long-term suppression
of replication of hepatitis B virus (HBV) by antiviral medications
to the fibrosis regression is not known exactly in the chronic
hepatitis B (CHB) patients. Since liver biopsy is an invasive
process, the importance of non-invasive tests in determining
fibrosis is increasing over recent years. Non- invasive fibrosis
markers have a lot of advantages such as absence of risks,
patient acceptance and being easy and repeatable. These tests
can be used for to follow-up liver fibrosis in CHB patients.
Aims: To evaluate the performance aspartate aminotransferase-
to-platelet ratio index [APRI] and fibrosis index based on
four factors [FIB-4 index]), and Fibroscan (Transient Elastography)
for the measurement of liver fibrosis in CHB patients
receiving oral antiviral therapy in long term follow-up period.
Methods: Demographic, histologic, clinical and laboratory
data of CHB patients receiving tenofovir disoproxil fumarate
and entecavir were recorded. Predicted fibrosis stage, based
on established scales and cut-off values for APRI, FIB-4 scores,
and Fibroscan was compared with Ishak scores obtained from
liver biopsy at baseline and at 7 years follow-up period Results:
A total of 168 patients with CHB (36.3% HBeAg positively)
were analyzed. The majority of patients (65.5%) were taking
tenofovir disoproxil fumarate. Seventy-nine percent of patients
with a baseline liver biopsy had Ishak fibrosis stage ≥2 (14.3%
had cirrhosis [Ishak 5 or 6]). The median APRI score was 0.69
(inter quarter range: 0.44–1.41), the median FIB-4 score was
1.19 (range: 0.72–2.02), the median Fibroscan was 7.4 (inter
quarter range: 5.9–9.5). FIB-4 scores (r=0.253, p=0.001)
and Fibroscan (r=0.292,p=0.002) correlated with fibrosis
stage. APRI did not correlate with fibrosis stage. The median
Fibroscan and FIB-4 scores at years 7th was 6.5 (inter quarter
range: 5.5–9.1) and 1.06 (range: 0.85–1.54). There is a
significant decrease in those values in both tests compared to
pre-treatment values in the 7th year of the treatment (P=0.022,
P<0.001). Conclusions: Fibroscan and FIB-4 scores are suitable
for assessment of hepatic fibrosis in CHB patients. Long-term
suppression of HBV can lead to regression of liver fibrosis and
cirrhosis.
Disclosures:
Iftihar Koksal - Advisory Committees or Review Panels: MSD, Abbvie, Gilead;
Speaking and Teaching: Gilead Sciences, BMS, MSD, Abbvie
The following people have nothing to disclose: Gurdal Yilmaz, Ilknur Yavuz 作者: StephenW 时间: 2016-10-30 21:22