Performance of FIB4 and APRI scores for the prediction of fibrosis in patients with chronic hepatitis B virus infection

Abstract

Background : The evaluation of hepatic fibrosis is essential in the therapeutic management of chronic hepatitis B virus infection. The development of non-invasive tests for liver fibrosis assessement has allowed to avoid liver biops in some cases.
Aim: To assess the performance of the scores APRI and FIB-4 in the assessment of significant fibrosis in chronic hepatitis B virus infection.
Methods: Evaluation study, including patients with chronic hepatitis B virus infection who had a liver biopsy. The accuracy of APRI and FIB4  for the detection of significant fibrosis was compared with  the liver biopsy data.

Results: One hundred and one patients were included. Significant fibrosis was found in 10.9% of patients. For a cut-off value of 0.49, the APRI score predicted significant fibrosis with a sensitivity of 54%, a specificity of 93% and a negative predictive value of 94%. For a cut-off value of 1.01, the FIB-4 score predicted significant fibrosis with a sensitivity of 64%, a specificity of 84% and a negative predictive value of 95%. Performance of both scores was influenced by age, the body mass index, and cytolysis.
Conclusion: The APRI and FIB-4 scores had a good accuracy to exclude significant fibrosis in chronic hepatitis B virus infection.