TITLE:
Interest of Non-Invasive Markers (APRI, FIB-4) for Assessing Hepatic Fibrosis in Patients with Chronic Viral Hepatitis B without Cytolysis and with Low Viral Replication
AUTHORS:
Mamadou Diakité, Kouassi Olivier Claver Koffi, Amadou Koné, Akoun Fabrice Aké, Oury Diallo Ahmadou, Stellart Jean M. Brou, Anassi Jean-Baptiste Okon
KEYWORDS:
HBV Infection, APRI, FIB-4, Impulse Elastography, Bouaké University Hospital
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.14 No.5,
May
31,
2024
ABSTRACT: Background and Objectives: The indication for treatment in HBsAg-positive patients with low viral load and normal transaminases requires an assessment of fibrosis. In resource-limited settings, free hepatic fibrosis evaluation tests can aid in therapeutic decision-making. Our study aims to demonstrate the utility of assessing hepatic fibrosis using non-invasive markers (APRI and FIB-4) in patients with chronic B viral hepatitis without cytolytic activity and low viral replication in our context. Patients and Methods: This is a retrospective cross-sectional study conducted between January 2018 and December 2021 at the University Hospital Center of Bouaké. Included were all patients aged ≥18 with normal transaminases (® was performed on all patients. APRI and FIB-4 scores were cal- culated. The diagnostic performance of fibrosis markers was analyzed using the receiver operating curve (ROC) to compare them. Sensitivity, specificity, positive and negative predictive values, and the area under the curve (AUROC) were calculated for each marker with a 95% confidence interval. A p-value Results: Our study included 241 patients, with a mean age of 36.19 years (±10.52 years) and a male predominance of 52%. The mean FibroScan® value was 6.44 ± 2.3 kPa, and 68 patients (28.22%) had fibrosis >7 kPa. To exclude significant fibrosis (FS Conclusion: A significant proportion of HBV-infected patients with normal ALT and low viral load have active liver disease. Both FIB-4 and APRI biological scores are useful in identifying individuals without significant fibrosis with a good negative predictive value (>50%).