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Diminished accuracy of biomarkers of fibrosis in low replicative chronic hepatitis B
BACKGROUND: We evaluated the diagnostic accuracy of aspartate aminotransferase (AST)-to-platelet ratio index (APRI), fibrosis-4 index (FIB-4), AST/alanine aminotransferase (ALT) ratio (AAR), and age-platelet index (API) for significant fibrosis (Metavir F2–4) in low-replicative (HBV DNA <20,000 I...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574089/ https://www.ncbi.nlm.nih.gov/pubmed/28841822 http://dx.doi.org/10.1186/s12876-017-0658-x |
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author | Sanai, Faisal M. Farah, Taha Albeladi, Khalid Batwa, Faisal Dahlan, Yaser Babatin, Mohammed A. Al-Ashgar, Hamad AlMana, Hadeel Alsaad, Khaled S. AlSwat, Khalid Aljumah, Abdulrahman AlTraif, Ibrahim H. Kailani, Bahaa E. Bzeizi, Khalid I. |
author_facet | Sanai, Faisal M. Farah, Taha Albeladi, Khalid Batwa, Faisal Dahlan, Yaser Babatin, Mohammed A. Al-Ashgar, Hamad AlMana, Hadeel Alsaad, Khaled S. AlSwat, Khalid Aljumah, Abdulrahman AlTraif, Ibrahim H. Kailani, Bahaa E. Bzeizi, Khalid I. |
author_sort | Sanai, Faisal M. |
collection | PubMed |
description | BACKGROUND: We evaluated the diagnostic accuracy of aspartate aminotransferase (AST)-to-platelet ratio index (APRI), fibrosis-4 index (FIB-4), AST/alanine aminotransferase (ALT) ratio (AAR), and age-platelet index (API) for significant fibrosis (Metavir F2–4) in low-replicative (HBV DNA <20,000 IU/mL) chronic hepatitis B virus (HBV) patients. METHODS: The sensitivity, specificity, and area under the receiver-operating characteristic curve (AUROC) of HBeAg-negative, low-replicative (n = 213) and high-replicative (HBV DNA ≥20,000 IU/mL, n = 153) patients was assessed. RESULTS: Overall, 113 patients (30.9%) had F2–4 fibrosis. Of the low and high-replicative patients, 40 (18.8%) and 73 (47.7%) had F2–4, respectively (P < 0.0001). APRI ≥0.5 less frequently identified F2–4 fibrosis in low vs. high-replicative patients (48.7% vs. 69.6%, P = 0.032) and AAR identified it more frequently in low-replicative patients (37.5% vs. 19.4%, P = 0.037). FIB-4 and API were not different (P > 0.05) for identifying F2–4 fibrosis in low and high-replicative patients. Higher specificities were seen at the lowest cut-offs in low vs. high-replicative states for APRI (≥0.5, 98% vs. 68.9%), AAR (84.3% vs. 76.6%), FIB-4 (≥1.45, 97.5% vs. 87.8%) and API (>4, 94.8% vs. 93.8%). At ROC-defined thresholds, APRI (≥0.33), AAR (≥0.93), FIB-4 (≥0.70) and API (>2) showed greater AUROCs for F2–4 diagnosis in low replicative (0.80, 0.62, 0.81 and 0.71, respectively) vs. high-replicative patients (0.73, 0.52, 0.67 and 0.69, respectively). CONCLUSION: All 4 biomarkers in both, low and high-replicative HBV demonstrate modest accuracy for fibrosis diagnosis at conventional cut-offs. Lowering the cut-offs may increase the diagnostic relevance of these biomarkers, particularly for APRI and FIB-4 in low-replicative disease. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12876-017-0658-x) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5574089 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-55740892017-08-30 Diminished accuracy of biomarkers of fibrosis in low replicative chronic hepatitis B Sanai, Faisal M. Farah, Taha Albeladi, Khalid Batwa, Faisal Dahlan, Yaser Babatin, Mohammed A. Al-Ashgar, Hamad AlMana, Hadeel Alsaad, Khaled S. AlSwat, Khalid Aljumah, Abdulrahman AlTraif, Ibrahim H. Kailani, Bahaa E. Bzeizi, Khalid I. BMC Gastroenterol Research Article BACKGROUND: We evaluated the diagnostic accuracy of aspartate aminotransferase (AST)-to-platelet ratio index (APRI), fibrosis-4 index (FIB-4), AST/alanine aminotransferase (ALT) ratio (AAR), and age-platelet index (API) for significant fibrosis (Metavir F2–4) in low-replicative (HBV DNA <20,000 IU/mL) chronic hepatitis B virus (HBV) patients. METHODS: The sensitivity, specificity, and area under the receiver-operating characteristic curve (AUROC) of HBeAg-negative, low-replicative (n = 213) and high-replicative (HBV DNA ≥20,000 IU/mL, n = 153) patients was assessed. RESULTS: Overall, 113 patients (30.9%) had F2–4 fibrosis. Of the low and high-replicative patients, 40 (18.8%) and 73 (47.7%) had F2–4, respectively (P < 0.0001). APRI ≥0.5 less frequently identified F2–4 fibrosis in low vs. high-replicative patients (48.7% vs. 69.6%, P = 0.032) and AAR identified it more frequently in low-replicative patients (37.5% vs. 19.4%, P = 0.037). FIB-4 and API were not different (P > 0.05) for identifying F2–4 fibrosis in low and high-replicative patients. Higher specificities were seen at the lowest cut-offs in low vs. high-replicative states for APRI (≥0.5, 98% vs. 68.9%), AAR (84.3% vs. 76.6%), FIB-4 (≥1.45, 97.5% vs. 87.8%) and API (>4, 94.8% vs. 93.8%). At ROC-defined thresholds, APRI (≥0.33), AAR (≥0.93), FIB-4 (≥0.70) and API (>2) showed greater AUROCs for F2–4 diagnosis in low replicative (0.80, 0.62, 0.81 and 0.71, respectively) vs. high-replicative patients (0.73, 0.52, 0.67 and 0.69, respectively). CONCLUSION: All 4 biomarkers in both, low and high-replicative HBV demonstrate modest accuracy for fibrosis diagnosis at conventional cut-offs. Lowering the cut-offs may increase the diagnostic relevance of these biomarkers, particularly for APRI and FIB-4 in low-replicative disease. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12876-017-0658-x) contains supplementary material, which is available to authorized users. BioMed Central 2017-08-25 /pmc/articles/PMC5574089/ /pubmed/28841822 http://dx.doi.org/10.1186/s12876-017-0658-x Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Sanai, Faisal M. Farah, Taha Albeladi, Khalid Batwa, Faisal Dahlan, Yaser Babatin, Mohammed A. Al-Ashgar, Hamad AlMana, Hadeel Alsaad, Khaled S. AlSwat, Khalid Aljumah, Abdulrahman AlTraif, Ibrahim H. Kailani, Bahaa E. Bzeizi, Khalid I. Diminished accuracy of biomarkers of fibrosis in low replicative chronic hepatitis B |
title | Diminished accuracy of biomarkers of fibrosis in low replicative chronic hepatitis B |
title_full | Diminished accuracy of biomarkers of fibrosis in low replicative chronic hepatitis B |
title_fullStr | Diminished accuracy of biomarkers of fibrosis in low replicative chronic hepatitis B |
title_full_unstemmed | Diminished accuracy of biomarkers of fibrosis in low replicative chronic hepatitis B |
title_short | Diminished accuracy of biomarkers of fibrosis in low replicative chronic hepatitis B |
title_sort | diminished accuracy of biomarkers of fibrosis in low replicative chronic hepatitis b |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574089/ https://www.ncbi.nlm.nih.gov/pubmed/28841822 http://dx.doi.org/10.1186/s12876-017-0658-x |
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