Abstract
Background
There have been still few valuable noninvasive models that can be used as indirect markers of liver fibrosis in chronic hepatitis B (CHB) infection.
Methods
In 374 patients with chronic hepatitis B virus infection, the correlation between the conventional parameters and significant fibrosis confirmed by liver biopsy was assessed using univariate analysis and logistic regression. A model was established and assessed by the receiver operating characteristic (ROC) curves. Then it was validated in 108 prospectively enrolled patients. A part of the patients were followed up with cirrhosis as the end point, using survival analysis to assess the prognostic value of the model.
Results
A model named AIAG was constructed consisting of age, international normalized ratio, albumin, and gamma-glutamyltransferase which could discriminate between CHB patients with and without significant fibrosis. The area under ROC curves was 0.842 (95% CI, 0.795–0.888) for the training group (n = 250) and 0.806 (95% CI, 0.730–0.882) for the validation group (n = 124). In the training group, using a cut-off score of <0.32, the presence of significant fibrosis could be excluded with high accuracy (90% negative predictive value); similarly, applying a cut-off score of >0.72, the presence of significant fibrosis could be correctly identified with high accuracy (93% positive predictive value). Similar results have been shown in the internal and external validation groups. In the follow-up study, we found that the AIAG score may have good prognostic values to predict the progression of clinically overt cirrhosis in CHB patients.
Conclusions
AIAG, a simple marker panel consisting of conventional parameters, could easily predict significant fibrosis with a high degree of accuracy.
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Acknowledgements
This study was supported by the National High Technology Research and Development Program of China (863 Program, no. 2006AA02A411).
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Wu, Sd., Ni, Yj., Liu, L. et al. Establishment and validation of a simple noninvasive model to predict significant liver fibrosis in patients with chronic hepatitis B. Hepatol Int 6, 360–368 (2012). https://doi.org/10.1007/s12072-011-9328-1
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DOI: https://doi.org/10.1007/s12072-011-9328-1