纤维化-4指数预测2075例慢性HBV感染患者的肝硬化风险和肝脏

StephenW

Fibrosis‐4 index predicts cirrhosis risk and liver‐related mortality in 2075 patients with chronic HBV infection
T.‐C. Tseng
C.‐J. Liu
T.‐H. Su
W.‐T. Yang
C.‐L. Chen
H.‐C. Yang
S. F.‐T. Kuo
C.‐H. Liu
P.‐J. Chen
D.‐S. Chen
J.‐H. Kao
First published: 30 March 2018
https://doi.org/10.1111/apt.14619

The Handling Editor for this article was Professor Geoffrey Dusheiko, and it was accepted for p ... More

Background

Fibrosis‐4 index (FIB‐4) is a surrogate marker for hepatic fibrosis in hepatitis B virus (HBV) carriers.
Aim

It remains unclear whether FIB‐4 index stratifies the risks of adverse liver events.
Methods

A total of 2075 treatment‐naïve, noncirrhotic the patients with chronic HBV infection were included. Most of them (82.1%) were HBeAg‐negative patients and their baseline FIB‐4 levels were explored to stratify the risks of cirrhosis, cirrhosis‐related complications and liver‐related mortality.
Results

During a mean follow‐up period of 15.47 years, we found a higher baseline FIB‐4 index was associated with increased incidence rates of cirrhosis in addition to the common host and viral factors. Patients with FIB‐4 >1.29, compared to those with FIB‐4 <1.29, were associated with increased risks of cirrhosis, cirrhosis‐related complications and liver‐related mortality with the hazard ratio (95% confidence interval) of 6.19 (4.76‐8.05), 6.88, (3.68‐12.86) and 7.79, (4.54‐13.37) respectively. Within the first 3 years of follow‐up, FIB‐4 remained stable and its kinetics were consistently associated with the develoopment of adverse liver events. Furthermore, FIB‐4 index of 1.29 was able to stratify all the risks of adverse liver events even in HBeAg‐negative patients with a low risk of disease progression (HBV DNA <2000 IU/mL, HBsAg <1000 IU/mL and ALT <40 U/L). Only 1 patient with FIB‐4 index <1.29 developed cirrhosis but not other events within 15 years of follow‐up.
Conclusions

In noncirrhotic patients with chronic HBV infection, a higher FIB‐4 index was associated with increased risks of adverse liver events. FIB‐4 index <1.29 is useful for the prediction of the lowest risks of disease progression.

StephenW

纤维化-4指数预测2075例慢性HBV感染患者的肝硬化风险和肝脏相关死亡率
T.-C.曾雅妮
C.-J.刘
T.-H.苏
W.-T.杨
C.-L.陈
H.-C.杨
S.F.-T.郭
C.-H刘
P.-J.陈
D.-S.陈
J.-H.花王
首次发布：2018年3月30日
https://doi.org/10.1111/apt.14619

这篇文章的处理编辑是杰弗里Dusheiko教授，它被接受为P ...更多

背景

纤维化-4指数（FIB-4）是乙肝病毒（HBV）携带者肝纤维化的替代指标。
目标

目前还不清楚FIB-4指数是否可以分层肝脏不良事件的风险。
方法

纳入了2075例未治疗的非慢性HBV慢性感染患者。他们中的大多数（82.1％）是HBeAg阴性患者，并且他们的基线FIB-4水平被用于分层分析肝硬化，肝硬化相关并发症和肝相关死亡的风险。
结果

在平均15.47年的随访期内，除常见宿主和病毒因素外，我们发现较高的基线FIB-4指数与肝硬化发病率增加相关。与FIB-4 <1.29相比，FIB-4> 1.29的患者与肝硬化，肝硬化相关并发症和肝相关死亡风险增加相关，风险比（95％可信区间）为6.19（4.76- 8.05），6.88，（3.68-12.86）和7.79，（4.54-13.37）。在随访的前3年内，FIB-4保持稳定，其动力学始终与发生不良肝脏事件相关。此外，1.29的FIB-4指数能够将不良肝脏事件的所有风险分层，即使在疾病进展风险低（HBVDNA <2000IU / 40 U / L）。仅1例FIB-4指数<1.29的患者发生肝硬化，但在随访15年内未发生其他事件。
结论

在慢性HBV感染的非肝硬化患者中，较高的FIB-4指数与不良肝脏事件的风险增加相关。 FIB-4指数<1.29可用于预测疾病进展的最低风险。

桦子

FIB-4=年龄×AST/ PLT计数×√ALT

StephenW

回复 桦子 的帖子

FIB-4=(年龄×AST)/ (PLT计数×√ALT)

PLT计数 (10**9/L)

https://www.hepatitisc.uw.edu/page/clinical-calculators/fib-4

纠结哥哥

回复 StephenW 的帖子

治疗前还是治疗后?

StephenW

回复 纠结哥哥 的帖子

在以上研究, FIB-4是基线测量, 观察随访开始时 - 患者先前都没有治疗.