Can We Accurately Assess Fibrosis in Chronic Hepatitis B Virus Patients?

Objectives: To compare the efficacy of blood biochemical indicators with imaging techniques and biopsy data in detecting liver fibrosis in patients with chronic hepatitis B (CHB).Materials and Methods: One hundred fifty-three CHB patients followed without treatment in the Infectious Diseases Hepatitis Outpatient Clinic between 2021 and 2023 at Ege University Medical Faculty Hospital. The aspartate aminotransferase/ alanine aminotransferase (AST/ALT) ratio, fibrosis-4 (FIB-4) score, aspartate aminotransferase platelet ratio index (APRI) score, and platelet (PLT) count were all calculated at the same time as the International Normalized Ratio (INR) level and FIB-4 score. Hepatobiliary system ultrasonography (USG) findings, demographic characteristics, hepatitis B virus (HBV)-DNA levels, ultrasound based elastographic imaging results, and liver biopsy results were assessed. With serum fibrosis markers, AST/ALT ratio, FIB-4 score, APRI score, INR level, PLT number and gender, age, HBV-DNA, liver damage levels via biopsy and ultrasound-based elastography and hepatobiliary system USG results and their relationship between each other were investigated.Results: Of the patients, 73 (47.7%) were male. The average age was 47.11 +/- 13.47 years. Being female, the AST/ALT ratio of more than 1 and being >40 years were found to be statistically significant. The rate of AST/ALT >1 was found to be significantly higher in patients with normal USG findings. The PLT count was found to be higher in the group with HBV-DNA >2000 IU/mL. The FIB-4 score was found to be higher only in males. There was no statistically significant difference between the genders in the APRI score; however, it was found to be higher in patients aged >40 years.Conclusion: To predict the progression to cirrhosis or hepatocellular carcinoma in CHB patients who do not match the treatment criteria per the Turkish CHB treatment reimbursement guideline, fibrosis risk was assessed using biochemical markers and radiological imaging techniques. However, it was determined that radiological imaging using serum markers is not a reliable way to predict fibrosis in its early stages.