Diagnostic accuracy of biochemical markers of fibrosis in black African patients with chronic hepatitis B

Alassan Kouamé Mahassadi, Alain Koffi Attia, Fulgence M. Yao Bathaix, Narcisse Baudouin Agbé, Stanislas Doffou, Henriette Ya Kissi, Isidore Mouhenou Diomandé, Paul Cales, Thérese Ndri-Yoman

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DOI: 10.4236/health.2010.212210                

Abstract

Contradictory results of the accuracy of bio-chemical markers to predict the stage of fibrosis in black African patients with chronic hepatitis B (CHB) were previously published. We con-ducted a prospective cohort study to determine the diagnostic accuracy of aspartate ami-notransferase to platelet ratio (APRI), aspartate aminotransferase to alanine aminotransferase ratio (AAR), platelet count, age-platelet (AP) in-dex, and FIB-4 index for the prediction of sig-nificant fibrosis or cirrhosis in 117 black African patients (median age: 38 years, males: 73 %) with CHB not previously treated. Among them, 45 had significant fibrosis and 18 had cirrhosis using the METAVIR score system. Factors as-sociated either with significant fibrosis or cir-rhosis were determined in logistic multivariate analysis. Areas under receiver operating curve were assessed and compared for APRI, AAR, AP index, FIB-4 index and platelet count. Sensitivity, specificity, positive and negative predictive values were determined for each biochemical markers. Multivariate analysis showed that as-partate aminotransferase (p<0.0001) and plate-lets (p=0.03) were the independent factors as-sociated with significant fibrosis and only platelets (p=0.01) were associated with cirrhosis. APRI (cut-off > 1.1) and FIB-4 index (cut-off > 2.1) ruled out significant fibrosis with high specific-ity of 84.7 % and 86.1 % respectively and nega-tive predictive values of 78.2 % and 72.9 % re-spectively. More accurately, APRI (cut-off > 0.63) or FIB-4 index (cut-off > 1.26) ruled out cirrhosis with high sensitivity of 94.4% and 88.9% and high negative predictive values of 98.1% and 96.3% respectively. In conclusion, APRI and FIB-4 index are simple readily available markers to exclude significant fibrosis or more accu-rately cirrhosis in black African patients with CHB.

Keywords

Non Invasive Models; Fibrosis; Cirrhsis; Hepatitis B; Sub-Saharan Africa

Conflicts of Interest

The authors declare no conflicts of interest.

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