Noninvasive Models for Predicting Liver Fibrosis in Individuals with Hepatitis D Virus/Hepatitis B Virus Coinfection in the Brazilian Amazon Region.
Noninvasive Models for Predicting Liver Fibrosis in Individuals with Hepatitis D Virus/Hepatitis B Virus Coinfection in the Brazilian Amazon Region.
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用于预测巴西亚马逊地区丁型肝炎病毒/乙型肝炎病毒混合感染个体肝纤维化的无创模型。
DOI：
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发表时间：
2020
影响因子：
3.3
通讯作者：
J. M. Villalobos
中科院分区：
文献类型：
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作者：
Mariana Pinheiro Alves Vasconcelos;Deusilene Souza Vieira Dallacqua;H. Wedemeyer;S. Witkin;M. Mendes;J. M. Villalobos
丁型肝炎病毒（HDV）基因型III是亚马逊河流域西部的地方病，被认为是导致最严重形式的慢性病毒性肝炎。最近，非侵入性纤维化评分，以确定肝纤维化的阶段已被评估的个体阳性的HDV基因型I，但其效用HDV基因型III阳性患者是未知的。在巴西亚马逊地区的一家病毒性肝炎门诊转诊诊所进行的这项回顾性研究中，计算了天冬氨酸转氨酶（AST）与天冬氨酸转氨酶与血小板比率指数（APRI）和肝纤维化纤维化指数（FIB-4）值，并与组织学纤维化分期进行了比较。在分析的50例患者中，肝活检时的中位年龄为35.6岁，66%为男性，且均患有代偿性肝病。组织学分期显示，分别有4例（8%）、8例（16%）、11例（22）、11例（22%）和16例（32%）患者的纤维化分期为0、1、2、3和4。AST/ALT比值、APRI和FIB-4检测显著纤维化（F ≥ 2）的受试者工作曲线下面积（AUROC）分别为0.550（P = 0.601）、0.853（P < 0.001）和0.853（P < 0.0001）。肝硬化的AUROC值较低：AST/ALT比值为0.640（P = 0.114），APRI为0.671（P = 0.053），FIB-4为0.701（P = 0.023）。APRI和FIB-4的显著纤维化的最佳截止值分别为0.708（敏感性84%，特异性92%）和1.36（敏感性76%，特异性92%）。天冬氨酸转氨酶与血小板比值指数和FIB-4对预测肝硬化的作用较小。与最近来自欧洲和北美的报道相反，APRI和FIB-4都可以识别巴西西北部HDV-III感染患者的显著纤维化。
Hepatitis D virus (HDV) genotype III is endemic in the western Amazon basin and is considered to cause the most severe form of chronic viral hepatitis. Recently, noninvasive fibrosis scores to determine the stage of liver fibrosis have been evaluated in individuals positive for HDV genotype I, but their utility in HDV genotype III-positive patients is unknown. In this retrospective study conducted in an outpatient viral hepatitis referral clinic in the Brazilian Amazon region, the aspartate aminotransferase (AST) to Aspartate aminotransferase to Platelet Ratio Index (APRI) and Fibrosis Index for Liver Fibrosis (FIB-4) values were calculated and compared with histological fibrosis stages. Among the 50 patients analyzed, the median age at liver biopsy was 35.6 years, 66% were male, and all had compensated liver disease. Histological staging revealed fibrosis stages 0, 1, 2, 3, and 4 in four (8%), eight (16%), 11 (22), 11 (22%), and 16 (32%) patients, respectively. The area under the receiver operating curve (AUROC) of AST-to-alanine aminotransferase (ALT) ratio, APRI, and FIB-4 for detection of significant fibrosis (F ≥ 2) was 0.550 (P = 0.601), 0.853 (P < 0.001), and 0.853 (P < 0.0001), respectively. Lower AUROC values were obtained for cirrhosis: the AST-to-ALT ratio was 0.640 (P = 0.114), APRI was 0.671 (P = 0.053), and FIB-4 was 0.701 (P = 0.023). The optimal cutoff value for significant fibrosis for APRI was 0.708 (sensitivity 84% and specificity 92%) and for FIB-4 was 1.36 (sensitivity 76% and specificity 92%). Aspartate aminotransferase to Platelet Ratio Index and FIB-4 were less useful to predict cirrhosis. In contrast to recent reports from Europe and North America, both APRI and FIB-4 may identify significant fibrosis in HDV-III-infected patients from northwestern Brazil.
影响因子：
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作者：
Johnm . Taylor
通讯作者：
Johnm . Taylor
影响因子：
6.4
作者：
Casey, JL;Niro, GA;Gerin, JL
通讯作者：
Gerin, JL