Diminished accuracy of biomarkers of fibrosis in low replicative chronic hepatitis B
Autor: | Faisal M. Sanai, Khalid Alswat, Taha Farah, Mohammed A. Babatin, Hamad I. Al-Ashgar, Hadeel AlMana, Khaled S. Alsaad, Khalid I. Bzeizi, Khalid Albeladi, Faisal Batwa, Abdulrahman Aljumah, Yaser Dahlan, Bahaa E. Kailani, Ibrahim Altraif |
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Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Adult
DNA Replication Liver Cirrhosis Male medicine.medical_specialty Pathology Hepatitis B virus Diagnostic accuracy Virus Replication Gastroenterology Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine Hepatitis B Chronic Chronic hepatitis Fibrosis Reference Values Internal medicine Medicine Humans Aspartate Aminotransferases Alanine aminotransferase lcsh:RC799-869 APRI business.industry Platelet Count Reproducibility of Results Alanine Transaminase General Medicine Hepatitis B Hepatology Middle Aged medicine.disease 030220 oncology & carcinogenesis Area Under Curve DNA Viral 030211 gastroenterology & hepatology Female lcsh:Diseases of the digestive system. Gastroenterology business Biomarkers Significant fibrosis Research Article |
Zdroj: | BMC Gastroenterology, Vol 17, Iss 1, Pp 1-7 (2017) BMC Gastroenterology |
Popis: | 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 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. |
Databáze: | OpenAIRE |
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