Applicability of APRI and FIB-4 as a transition indicator of liver fibrosis in patients with chronic viral hepatitis
Applicability of APRI and FIB-4 as a transition indicator of liver fibrosis in patients with chronic viral hepatitis
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DOI：
10.1007/s00535-021-01782-3
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发表时间：
2021-03-31
影响因子：
6.3
通讯作者：
Kanto, Tatsuya
中科院分区：
文献类型：
--
作者：
Itakura, Jun;Kurosaki, Masayuki;Kanto, Tatsuya
背景和目的 APRI 或 FIB-4 作为慢性肝病患者诊断时的非侵入性肝纤维化标志物的有效性已得到充分证实。然而，它们对于监测肝纤维化随时间的进展的适用性尚未确定。我们的目的是阐明APRI和FIB-4用于纵向评估慢性乙型和丙型肝炎患者肝纤维化的可行性。方法这是一项多中心回顾性和前瞻性队列研究，纳入经肝活检组织学诊断的1029例HCV患者和384例HBV患者。回顾性研究和前瞻性研究的观察期分别为14年和12年。对组织学诊断为肝硬化的病例追溯 APRI 和 FIB-4，对诊断为 METAVIR 评分 F3 的病例进行活检后前瞻性分析。结果 在丙型肝炎患者的回顾性研究中，平均 APRI 和 FIB-4 表现出时间依赖性增加（APRI 增加 0.09/年，FIB-4 增加 0.29/年）。在对未经治疗的丙型肝炎患者进行的前瞻性研究中，APRI 的这种增加为 0.14/年，FIB-4 的增加为 0.40/年。乙型肝炎患者和接受过治疗的丙型肝炎患者的 APRI 平均值和 FIB-4 平均值均未显示出特定趋势。结论 APRI和FIB-4可作为初治慢性丙型肝炎患者肝纤维化的过渡指标。
Background and Aims The usefulness of APRI or FIB-4 is well established as a non-invasive liver fibrosis marker at a point of diagnosis in patients with chronic liver disease. However, their applicability for the monitoring of progression of liver fibrosis over time is yet to be determined. We aimed to clarify the feasibility of APRI and FIB-4 for the longitudinal evaluation of liver fibrosis in patients with chronic hepatitis B and C. Methods This is a multi-center retrospective and prospective cohort study, enrolling 1029 patients with HCV and 384 patients with HBV who were histologically diagnosed by liver biopsy. The observation period of retrospective and prospective study was 14 and 12 years, respectively. The APRI and FIB-4 were traced back in cases of histologically diagnosed cirrhosis, and those were prospectively analyzed after biopsy in cases diagnosed as F3 of METAVIR score, respectively. Results The averaged APRI and FIB-4 exhibited time-dependent increase in the retrospective study of hepatitis C patients (increase by 0.09/year in APRI and 0.29/year in FIB-4). In the prospective study of untreated hepatitis C patients, such increases were 0.14/year in APRI and 0.40/year in FIB-4, respectively. Neither the average of APRI nor FIB-4 showed a specific tendency with hepatitis B patients and treatment-experienced hepatitis C patients. Conclusion The APRI and FIB-4 may serve as a transition indicator of liver fibrosis in anti-viral treatment-naive patients with chronic hepatitis C.