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Alloveda Liver Update: Performance of Non-invasive Blood Parameters to Rule out Significant Liver Fibrosis in Patients with CHB

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eMediNexus    19 July 2020

It is important to assess significant liver fibrosis in order to make treatment decisions and to determine treatment response in patients with chronic hepatitis B. Liver biopsy is an invasive procedure and transient elastography (TE) has limited availability. There is a need to evaluate non-invasive blood parameters for detecting significant fibrosis.

A retrospective study was conducted to assess the records of patients who underwent liver biopsy for treatment-naïve chronic hepatitis B and non-invasive blood parameters, including aspartate aminotransferase-to-platelet ratio index [APRI], fibrosis-4 score [FIB-4], gamma-glutamyl transpeptidase-to-platelet ratio [GPR], and gamma-glutamyl transpeptidase-to-albumin ratio [GAR]), were obtained, besides TE. Investigators evaluated significant liver fibrosis and compared these to fibrosis stage in liver biopsy.

The study included 113 patients, median age 33 (74% males). Around 75% of the patients were found to be HBeAg-negative. Significant fibrosis (Ishak ≥3) was evident in 13% of the patients while nil or mild fibrosis (Ishak <3) was noted in 87% on liver biopsy. TE findings were available for 85 patients, APRI and FIB-4 for 95 patients, GPR for 79 patients, and GAR for 78 patients. Patients with significant fibrosis had significantly higher median values of these parameters, compared to those with non-significant fibrosis. All the blood parameters and TE could successfully detect patients with significant fibrosis (p<0.05). The positive predictive value for all the non-invasive parameters was low; however, the negative predictive value was >92%. In comparison with TE, non-invasive blood parameters had similar area under the curve for detecting significant fibrosis, with negative predictive value of ≥93%.

Non-invasive blood parameters assessed in this study, including APRI, FIB-4, GPR, and GAR, with negative predictive values over 93% are robust parameters to rule-out significant fibrosis in patients with chronic hepatitis B and can be used in place of TE.

Source: Khare S, Arora A, Sharma P, et al. Performance of Non-invasive Blood Parameters for Ruling Out Significant Liver Fibrosis in Patients with Chronic Hepatitis B. Journal of Clinical and Translational Hepatology 2020;8(2):143-9.

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