Diagnostic Performance of Non-invasive Fibrosis Indexes in Hepatitis B Related Fibrosis

Objectives: The aim of this study was to evaluate the diagnostic performance of non-invasive fibrosis markers [AST to platelet ratio (APRI), Fibrosis Index based on four factors (FIB-4) Index, AST/platelet/GGT/Alpha-fetoprotein (AFP) Index (APGA), FI, Fibro-quotient (FibroQ), AST/ALT ratio (AAR), GGT/Platelet ratio (GPR), Platelet-agephosphatase-AFP-AST (PAPAS) and S-Index] in chronic hepatitis b (CHB) patients. Materials and Methods: Treatment naive CHB patients who underwent liver biopsy were screened. Four hundred seventeen patients were included in the study. Fibrosis stage was reevaluated according to ISHAK score. The diagnostic efficacy of non-invasive fibrosis indicators for significant fibrosis (>= F3) and cirrhosis (>= F5) was evaluated. The diagnostic performance of the non-invasive markers was defined as the AUROC value of >= 0.9 as excellent, 0.9> AUROC >= 0.8 as good, 0.8> AUROC >= 0.7 as moderate and AUROC <0.7 as poor. Results: AUROC values of S-index, GPR, APRI, FIB-4 index, FibroQ and PAPAS for diagnosing significant fibrosis were 0.683, 0.667, 0.679, 0.679, 0.585, 0.606 respectively. AUROC values of S-Index, GPR, APGA and FIB-4 index, APRI, FibroO, PAPAS, Fl for diagnosing cirrhosis were 0.841, 0.833, 0.819, 0.802, 0.767, 0.700, 0.697, 0.620 respectively. Conclusion: Diagnostic performance of S-Index for diagnosing cirrhosis and significant fibrosis was found superior to other indexes, but diagnostic performance of all these indexes was poor in predicting significant fibrosis. Diagnostic performance of S-Index, APGA, GPR, and FIB-4 index were good in determining cirrhosis.