Comparison and Value of Non-Invasive Tests in Chronic Hepatitis B and C Versus Liver Biopsy
Recep Balık1, Tuna Demirdal2, Serap Ural2, Salih Atakan Nemli2, Selin Özdemir2, Ümmü Sena Sarı21Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Türkiye, Istanbul Haydarpasa Numune Training and Research Hospital, Istanbul, Türkiye2Department of Infectious Diseases and Clinical Microbiology, Izmir Katip Celebi University, Atatürk Training and Research Hospital, Izmir, Türkiye
INTRODUCTION: The aim of this study is to evaluate the performance of non-invasive tests, including APRI, FIB-4, and FibroIndex, in detecting fibrosis in patients with chronic hepatitis B and C compared to liver biopsy.
METHODS: This study enrolled 236 patients with CHB/CHC who underwent ultrasound-guided liver biopsies between January 2007 and May 2014 at Katip Çelebi University Atatürk Training and Research Hospital. Histological grading of necroinflammation and fibrosis was performed according to the Knodell and ISHAK scoring systems. APRI, FIB-4, and FibroIndex scores were calculated based on their respective formulas. Optimal cutoffs were determined using the Youden method. Sensitivity and specificity were calculated for significant fibrosis and cirrhosis. Statistical analyses were performed using SPSS.
RESULTS: This study evaluated 236 patients with chronic hepatitis B (CHB) and C (CHC) using non-invasive tests to diagnose liver fibrosis and cirrhosis. CHB was more prevalent, accounting for 77.5% of cases, with a slight male predominance in the cohort. Non-invasive tests such as APRI, FIB-4, and FibroIndex demonstrated moderate to good diagnostic accuracy, with better performance generally observed in CHC patients. For instance, APRI exhibited excellent sensitivity and specificity for cirrhosis in CHC. These findings suggest that the effectiveness of these tests varies based on hepatitis type, highlighting the potential need for different diagnostic strategies depending on viral etiology.
DISCUSSION AND CONCLUSION: Non-invasive tests proved to be useful tools for detecting significant fibrosis and cirrhosis. Additionally, FibroIndex demonstrated superior performance with higher sensitivity and specificity compared to other non-invasive tests.
Manuscript Language: English