Author/Authors :
Tanoglu Alpaslan نويسنده Department of Gastroenterology,
GATA Haydarpasa Training Hospital , Akdeniz Hayrettin نويسنده Department
of Infectious Diseases and Clinical Microbiology, Abant Izzet Baysal University,
Faculty of Medicine, Bolu, Turkey , Keten Derya نويسنده Department of
Clinical Microbiology and Infectious Diseases, Necip Fazil City Hospital,
Kahramanmaras, Turkey , Sumer Sua نويسنده Department of Infectious Diseases
and Clinical Microbiology, Selcuk University Faculty of Medicine, Konya, Turkey
, Sayan Murat نويسنده Kocaeli University Faculty of Medicine, PCR Unit, Clinical
Laboratory, Kocaeli, Turkey , Aygen Bilgehan نويسنده Department of Infectious Diseases and Clinical
Microbiology, Erciyes University Faculty of Medicine, Kayseri,
Turkey , Sirmatel Fatma نويسنده Department of Infectious Diseases and Clinical
Microbiology, Abant Izzet Baysal University Faculty of Medicine,
Bolu, Turkey , Eren Tulek Necla نويسنده Department of Infectious Diseases and Clinical
Microbiology, Ankara Training and Research Hospital, Ankara,
Turkey , Aktug Demir Nazlim نويسنده Department of Infectious Diseases and Clinical
Microbiology, Selcuk University Faculty of Medicine, Konya,
Turkey , Korkmaz Fatime نويسنده Department of Infectious Diseases and Clinical
Microbiology, Konya Training and Research Hospital, Konya,
Turkey , Ural Onur نويسنده Department of Infectious Diseases and Clinical
Microbiology, Selcuk University Faculty of Medicine, Konya,
Turkey , Demirturk Nese نويسنده Department of Infectious Diseases and Clinical
Microbiology, Kocatepe University Faculty of Medicine, Afyon,
Turkey , Karagoz Ergenekon نويسنده Fatih Sultan Mehmet Training and Research Hospital,
Istanbul, Turkey , Korkmaz Pinar نويسنده Dumlupinar University Faculty of Medicine, Department of
Infectious Diseases and Clinical Microbiology, Kutahya,
Turkey , Batırel Ayse نويسنده Kartal Dr. Lutfi K?rdar Training and Research Hospital,
Department of Infectious Diseases and Clinical Microbiology,
Istanbul, Turkey , Cem Yardimci Ahmet نويسنده Sanliurfa Training and Research Hospital, Department of
Infectious Diseases and Clinical Microbiology, Sanl?urfa,
Turkey , Cagir Unal نويسنده Nevsehir State Hospital, Department of Infectious Diseases
and Clinical Microbiology, Nevsehir, Turkey , Atakan Nemli Salih نويسنده Izmir Katip Celebi University Faculty of Medicine,
Department of Infectious Diseases and Clinical Microbiology, Izmir,
Turkey , Zeynep Akcam Fusun نويسنده Suleyman Demirel University Faculty of Medicine,
Department of Infectious Diseases and Clinical Microbiology,
Isparta, Turkey , Sener Barut Huseyin نويسنده Gaziosmanpasa University Faculty of Medicine, Department
of Infectious Diseases and Clinical Microbiology, Tokat,
Turkey , Bayrak Burcu نويسنده Istanbul Training and Research Hospital, Department of
Infectious Diseases and Clinical Microbiology, Istanb
Abstract :
Background Many noninvasive methods, including aspartate amino
transaminase (AST)/alanine amino transaminase (ALT) ratio (AAR),
AST-to-platelet ratio index (APRI), Bonacini cirrhosis discriminant
score (CDS), fibrosis-4 (FIB4) index, and age-platelet index (API), have
been described to determine the stage of hepatic fibrosis. However,
these methods are developed for patients with chronic hepatitis C (CHC)
and produce conflicting results in the prediction of liver fibrosis in
patients with chronic hepatitis B (CHB). Objectives The aim of this
study was to evaluate the relationship between 7 noninvasive models,
including AAR, APRI, CDS, API, FIB-4, neutrophil-to-lymphocyte ratio
(NLR), and red cell distribution width (RDW)-to-platelet ratio (RPR) in
patients with CHB. Methods The study population included all patients
with CHB, undergoing liver biopsy to determine HBsAg and HBV DNA
positivity in more than 6 months. Results A total of 2520
treatment-naive CHB patients from 40 different centers were included in
the study. In total, 62.6% of the patients were male, and the mean age
was 40.60 ± 12.34 years (minimum, 18 years; maximum, 77 years). The
Ishak fibrosis score was ≥ 3 in 29.8% of the patients, indicating
significant fibrosis. The mean API, APRI, CDS, NLR, FIB4, and RPR scores
in the noninvasive models were significantly different between the
groups with significant and low fibrosis (P < 0.05). All the
noninvasive models (API, APRI, AAR, CDS, NLR, RPR, and FIB4) were found
to be significant in the discrimination of cirrhosis (P < 0.05).
In the multiple logistic regression analysis, CDS, albumin, alkaline
phosphatase (ALP), total bilirubin, neutrophil count, NLR, mean platelet
volume (MPV), and FIB4 were independent indices for cirrhosis.
Conclusions In the present study, the role of noninvasive tests in the
prediction of liver fibrosis stage and cirrhosis was evaluated in a
large cohort of CHB patients. Overall, noninvasive models are gradually
becoming more promising. Accordingly, the need for liver biopsy can be
reduced with a combination of noninvasive methods in the future.
