Universität zu Köln

Lang, Sonja, Kutting, Fabian, Staub, Agnes, Schramowski, Jessica, Schramm, Christoph, Kasper, Philipp, Goeser, Tobias, Steffen, Hans-Michael and Demir, Muevver (2017). Performance of simple noninvasive scoring systems for the prediction of advanced fibrosis in patients with chronic hepatitis B. Eur. J. Gastroenterol. Hepatol., 29 (11). S. 1235 - 1241. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1473-5687

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Abstract

Background and aim The aim of the study was to analyze the diagnostic performance and clinical utility of simple noninvasive tests for the detection of advanced fibrosis in patients with chronic hepatitis B (CHB) infection seen at a tertiary referral center in Germany. Patients and methods We retrospectively analyzed 239 adult CHB patients with available liver biopsies. Patient demographics, hepatitis B markers, antiviral treatment, laboratory parameters, results from liver imaging, and histology were recorded. The sensitivity, specificity, and positive and negative predictive values were determined along with the area under receiver operating characteristic curves (AUROC) using published formulas and cut-off values for fibrosis index based on the four factors, aspartate aminotransferase-alanine aminotransferase ratio index (AAR), aspartate aminotransferase-to-platelet ratio index (APRI), and age-platelet index. Results The median documented duration of CHB infection was 31 months (range: 6-340 months); 86% of the patients were Caucasian and 71% were men. The AUROCs for the detection of advanced fibrosis were 0.75 [ 95% confidence interval (CI): 0.67-0.82], 0.72 (95% CI: 0.64-0.80), 0.48 (95% CI: 0.39-0.56), and 0.73 (95% CI: 0.66-0.81) for fibrosis index the four factors, APRI, AAR, and age-platelet index, respectively. Patients with advanced fibrosis on biopsy were misclassified as having mild fibrosis in 35% (APRI) to 82% (AAR) of cases. Conclusion Because of their moderate test performance (AUROCs: 0.48-0.75) and their high misclassification rate, we could not confirm a reliable clinical utility for the analyzed noninvasive fibrosis scoring systems for the prediction of advanced fibrosis in mostly Caucasian CHB patients. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lang, Sonja UNSPECIFIED UNSPECIFIED UNSPECIFIED Kutting, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Staub, Agnes UNSPECIFIED UNSPECIFIED UNSPECIFIED Schramowski, Jessica UNSPECIFIED UNSPECIFIED UNSPECIFIED Schramm, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Kasper, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Goeser, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Steffen, Hans-Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Demir, Muevver UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-212767
DOI:	10.1097/MEG.0000000000000977
Journal or Publication Title:	Eur. J. Gastroenterol. Hepatol.
Volume:	29
Number:	11
Page Range:	S. 1235 - 1241
Date:	2017
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1473-5687
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LIVER FIBROSIS; HEPATOCELLULAR-CARCINOMA; VIRUS INFECTION; C VIRUS; INDEX; CIRRHOSIS; FIB-4; APRI; DIAGNOSIS; ACCURACY Multiple languages Gastroenterology & Hepatology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21276