The value of APRI and FIB-4 scores in detection of liver fibrosis of patients with chronic hepatitis C

Hatice Burcu Açıkalın Arıkan; Tuna Demirdal; Neriman Bilir

Article Details

The value of APRI and FIB-4 scores in detection of liver fibrosis of patients with chronic hepatitis C

Authors:

Hatice Burcu Açıkalın Arıkan | Tuna Demirdal | Neriman Bilir

Publisher:

Cukurova University

Main Topics:

Klinik Tıp Bilimleri

Journal:

Cukurova Medical Journal Vol.48 Issue 2, pp.663-668

Document Type:

Article

Publication Date:

2/2023

Document Language:

English

Document ID (Org No.):

2001286370

pISSN:

2602-3032

Keywords:

Abstract:

 Purpose: Infection with hepatitis C virus causes chronic liver damage, fibrosis and in later processes, cirrhosis and liver cancer. Currently, the use of biomarkers, instead of invasive procedures, is recommended to identify liver fibrosis. In this study, we aimed to evaluate the sensitivity and specificity of aspartate aminotransferase AST to Platelet Ratio Index APRI and Fibrosis-4 Index FIB-4 scoring for detection of significant fibrosis in chronic hepatitis C patients. Materials and Methods: Liver biopsy results and blood test results of 50 patients, infected with chronic hepatitis C, were analyzed. APRI and FIB-4 scores were calculated. Sensitivity, specificity, positive predictive value PPV, negative predictive value NPV and consistency for APRI and FIB-4 scorings were calculated using a fourfold table. The values of APRI and FIB-4, providing the best specificity and sensitivity in the diagnosis of significant fibrosis, was determined by ROC receiver operator characteristics curve analysis. Results: The mean fibrosis stage of 30 patients with significant fibrosis was 2.830.74 and the mean patient age was 56.813. The sensitivity of APRI  1.5 to detect significant fibrosis was 16, the specificity was 90, PPV was 71 and NPV was 41. A FIB-4 score of 3.25 had a sensitivity of 20, a specificity of 95, a PPV of 85 and a NPV of 44. Conclusion: APRI and FIB-4 have high specificity and PPV in demonstrating significant fibrosis, but have low sensitivity and NPV. The sensitivity of FIB-4 was higher compared to the APRI scoring. More research on this subject is needed, as well as revision of fibrosis scores and development of new fibrosis scores.

 Purpose: Infection with hepatitis C virus causes chronic liver damage, fibrosis and in later processes, cirrhosis and liver cancer. Currently, the use of biomarkers, instead of invasive procedures, is recommended to identify liver fibrosis. In this study, we aimed to evaluate the sensitivity and specificity of aspartate aminotransferase AST to Platelet Ratio Index APRI and Fibrosis-4 Index FIB-4 scoring for detection of significant fibrosis in chronic hepatitis C patients. Materials and Methods: Liver biopsy results and blood test results of 50 patients, infected with chronic hepatitis C, were analyzed. APRI and FIB-4 scores were calculated. Sensitivity, specificity, positive predictive value PPV, negative predictive value NPV and consistency for APRI and FIB-4 scorings were calculated using a fourfold table. The values of APRI and FIB-4, providing the best specificity and sensitivity in the diagnosis of significant fibrosis, was determined by ROC receiver operator characteristics curve analysis. Results: The mean fibrosis stage of 30 patients with significant fibrosis was 2.830.74 and the mean patient age was 56.813. The sensitivity of APRI  1.5 to detect significant fibrosis was 16, the specificity was 90, PPV was 71 and NPV was 41. A FIB-4 score of 3.25 had a sensitivity of 20, a specificity of 95, a PPV of 85 and a NPV of 44. Conclusion: APRI and FIB-4 have high specificity and PPV in demonstrating significant fibrosis, but have low sensitivity and NPV. The sensitivity of FIB-4 was higher compared to the APRI scoring. More research on this subject is needed, as well as revision of fibrosis scores and development of new fibrosis scores.

 Purpose: Infection with hepatitis C virus causes chronic liver damage, fibrosis and in later processes, cirrhosis and liver cancer. Currently, the use of biomarkers, instead of invasive procedures, is recommended to identify liver fibrosis. In this study, we aimed to evaluate the sensitivity and specificity of aspartate aminotransferase AST to Platelet Ratio Index APRI and Fibrosis-4 Index FIB-4 scoring for detection of significant fibrosis in chronic hepatitis C patients. Materials and Methods: Liver biopsy results and blood test results of 50 patients, infected with chronic hepatitis C, were analyzed. APRI and FIB-4 scores were calculated. Sensitivity, specificity, positive predictive value PPV, negative predictive value NPV and consistency for APRI and FIB-4 scorings were calculated using a fourfold table. The values of APRI and FIB-4, providing the best specificity and sensitivity in the diagnosis of significant fibrosis, was determined by ROC receiver operator characteristics curve analysis. Results: The mean fibrosis stage of 30 patients with significant fibrosis was 2.830.74 and the mean patient age was 56.813. The sensitivity of APRI  1.5 to detect significant fibrosis was 16, the specificity was 90, PPV was 71 and NPV was 41. A FIB-4 score of 3.25 had a sensitivity of 20, a specificity of 95, a PPV of 85 and a NPV of 44. Conclusion: APRI and FIB-4 have high specificity and PPV in demonstrating significant fibrosis, but have low sensitivity and NPV. The sensitivity of FIB-4 was higher compared to the APRI scoring. More research on this subject is needed, as well as revision of fibrosis scores and development of new fibrosis scores.

 Amaç: Kronik hepatit C enfeksiyonu kronik karaciğer hasarına, inflamasyona, fibrozise ve ilerleyen süreçlerde siroz ve karaciğer kanserine sebep olmaktadır. Günümüzde, karaciğer fibrozunu tanımlamak için invaziv prosedürler yerine biyobelirteçlerin kullanılması tavsiye edilmektedir. Bu çalışmada, kronik hepatit C hastalarında belirgin fibrozisi saptamada aspartat aminotransferaz AST Trombosit Oranı İndeksi APRI ve Fibrozis-4 İndeksi FIB-4 skorlamalarının duyarlılık ve özgüllükleri araştırılmıştır. Gereç ve Yöntem: Kronik hepatit C ile enfekte 50 hastanın karaciğer biyopsi sonuçları ve kan sonuçları analiz edildi. APRI ve FIB-4 puanları hesaplandı. APRI ve FIB-4 skorlamaları için duyarlılık, özgüllük, pozitif prediktif değer PPD, negatif prediktif değer NPD ve tutarlılığı dört gözlü tablo ile hesaplandı. APRI ve FIB-4ün belirgin fibrozis tanısındaki en iyi spesifite ve sensitiviteye sahip değeri ROC reciever operator characteristics curve analizi ile belirlendi. Bulgular: Belirgin fibrozu olan 30 hastanın ortalama fibrozis evresi 2,830,74 ve ortalama hasta yaşı 56,813 idi. APRI  1.5in belirgin fibrozisi saptama duyarlılığı 16, özgüllüğü 90, PPD 71 ve NPD 41 idi. FIB-4 skorunun 3,25 olmasının duyarlılığı 20, özgüllüğü 95, PPD 85 ve NPD 44 olarak bulundu. Sonuç: Belirgin fibrozisi saptamada APRI ve FIB-4ün özgüllük ve PPDsi yüksek olmasına rağmen duyarlılığı ve NPDsi düşüktür. FIB-4 skorunun duyarlılığı APRIden daha yüksektir. Bu konuda daha fazla araştırmaya, fibrozis skorlarının revize edilmesine ve yeni fibrozis skorları geliştirilmesine ihtiyaç vardır.

Article Details

The value of APRI and FIB-4 scores in detection of liver fibrosis of patients with chronic hepatitis C

Authors:

Hatice Burcu Açıkalın Arıkan | Tuna Demirdal | Neriman Bilir

Publisher:

Cukurova University

Main Topics:

Klinik Tıp Bilimleri

Journal:

Cukurova Medical Journal Vol.48 Issue 2, pp.663-668

Document Type:

Article

Publication Date:

2/2023

Document Language:

English

Document ID (Org No.):

2001286370

pISSN:

2602-3032

APRI

AST

Chronic hepatitis C

FIB-4

Significant fibrosis

APRI

AST

Kronik hepatit C

FIB-4

Belirgin fibrozis

Issues

Article Details

Authors: Hatice Burcu Açıkalın Arıkan | Tuna Demirdal | Neriman Bilir

Publisher: Cukurova University

Main Topics: Klinik Tıp Bilimleri

Journal: Cukurova Medical Journal Vol.48 Issue 2, pp.663-668

Document Type: Article

Publication Date: 2/2023

Document Language: English

Document ID (Org No.): 2001286370

pISSN: 2602-3032

Issues

Authors:

Hatice Burcu Açıkalın Arıkan | Tuna Demirdal | Neriman Bilir

Publisher:

Cukurova University

Main Topics:

Klinik Tıp Bilimleri

Journal:

Cukurova Medical Journal Vol.48 Issue 2, pp.663-668

Document Type:

Article

Publication Date:

2/2023

Document Language:

English

Document ID (Org No.):

2001286370

pISSN:

2602-3032