AASLD2016[1839]APRI，FIB-4和Fibroscan的诊断性能

StephenW

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

StephenW

AASLD2016 APRI，FIB-4和Fibroscan的诊断性能
APRI，FIB-4和Fibroscan的诊断性能
用于评估慢性乙型肝炎的肝纤维化
接受口服抗病毒治疗的患者; 7年的现实生活
数据
Iftihar Koksal1，Gurdal Yilmaz1，Ilknur Yavuz2,1; 1感染性疾病，
黑海技术大学医学院，特拉布宗，
火鸡; 2吉林大学医学院传染病
学院，特拉布宗，土耳其
背景：晚期肝纤维化的回归是其中之一
肝病学的新概念。长期抑制的作用
的乙型肝炎病毒（HBV）的抗病毒药物的复制
到纤维化的回归是不完全在慢性中知道的
乙型肝炎（CHB）患者。由于肝活检是侵入性的
过程，非侵入性测试在确定的重要性
纤维化近年来增加。非侵入性纤维化
标志物有很多优点，如缺乏风险，
患者接受和容易和可重复。这些测试
可用于随访CHB患者的肝纤维化。
目的：评估性能天冬氨酸转氨酶 -
血小板比指数[APRI]和纤维化指数
四个因子[FIB-4指数]）和Fibroscan（瞬时弹性成像）
用于测量CHB患者的肝纤维化
在长期随访期接受口服抗病毒治疗。
方法：人口统计学，组织学，临床和实验室
接受替诺福韦地索普西富马酸盐的CHB患者的数据
和恩替卡韦。预测纤维化分期，基于
对APRI，FIB-4评分的确定量表和临界值，
和Fibroscan与从中获得的Ishak评分进行比较
肝活检在基线和7年随访期结果：
共有168例CHB（36.3％HBeAg阳性）
分析。大多数患者（65.5％）正在服用
替诺福韦地索普西富马酸盐。 79％的患者
与基线肝活检有Ishak纤维化分期≥2（14.3％
有肝硬化[Ishak 5或6]）。中位APRI评分为0.69
（四分之一范围：0.44-1.41），中位数FIB-4评分
1.19（范围：0.72-2.02），中值Fibroscan为7.4（中间）
1/4范围：5.9-9.5）。 FIB-4评分（r = 0.253，p = 0.001）
和Fibroscan（r = 0.292，p = 0.002）与纤维化相关
阶段。 APRI与纤维化分期无关。中位数
Fibroscan和FIB-4评分在第7年是6.5（季度
范围：5.5-9.1）和1.06（范围：0.85-1.54）。这里有一个
这两个测试中的值相比的显着降低
治疗前7年的治疗前（P = 0.022，
P <0.001）。结论：Fibroscan和FIB-4评分是合适的
用于评估CHB患者的肝纤维化。长期
抑制HBV可导致肝纤维化消退
肝硬化。
披露：
Iftihar Koksal - 咨询委员会或审查小组：MSD，Abbvie，Gilead;
讲座和教学：吉利德科学，BMS，MSD，Abbvie
以下人没有什么可披露：Gurdal Yilmaz，Ilknur Yavuz

四十己过

结论：Fibroscan和FIB-4评分是合适的用于评估CHB患者的肝纤维化。长期抑制HBV可导致肝纤维化消退

飞波和FIB4是可信的。长期抗病毒是有助于纤维化逆转的。