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 e...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 (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<sup>®</sup> 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%).展开更多
Hepatitis C infection in people living with Human Immunodeficiency Virus (HIV) poses management challenges. Of the world’s population, 3% are estimated to have chronic Hepatitis C Virus (HCV) infection, which is resp...Hepatitis C infection in people living with Human Immunodeficiency Virus (HIV) poses management challenges. Of the world’s population, 3% are estimated to have chronic Hepatitis C Virus (HCV) infection, which is responsible for about 70% of cases of chronic hepatitis (accelerated chronicity in the presence of HIV and for such major complications as cirrhosis and hepatocellular carcinoma. The fibrosis 4 (FIB-4) and Aspartate aminotransferase/platelet ratio index (APRI) scores are simple, inexpensive tests accessible to most people, and their performance has not yet been studied in C?te d’Ivoire. Objective: To prospectively evaluate the diagnostic performance of APRI and FIB-4 scores in liver damage in those co-infected with HIV/HCV in C?te d’Ivoire. Methods: This study was conducted over three months. The patients came from national blood transfusion center of the cities of Man and Daloa. The criteria for selecting respondents were at least 18 years of age and a positive test for HIV and HCV. APRI and FIB-4 scores were calculated for each patient from biological data obtained by COBAS C311 (Roche Hitachi, Japan). Statistical analyses were performed using GraphPad and MED-CALC software. Results: Our study involved 30 patients (men) of middle age (25 - 52 years), with extremes ranging from 0.67 to 8 for APRI and 0.201 to 22 for FIB-4. A predictive APRI and FIB4 score of significant hepatic fibrosis was observed in 23% of patients;however, 46% and 54% of patients for the APRI and FIB-4 score, respectively, would not have significant fibrosis. An APRI and FIB4 score not included in the classification limits of the type of fibrosis hepatitis was observed in 31% and 23% of patients, respectively. Conclusion: The performance of the APRI and FIB-4 biological scores analyzed according to the interpretation of their cut-off values would enable classifying about 70% and 77%, respectively, of the patient population in the stages of hepatitis C fibrosis.展开更多
目的探讨FIB-4(fibrosis index based on the 4 factor)指数对慢性乙型肝炎患者肝纤维化诊断价值。方法检测86例慢性乙肝患者血清ALT(谷丙转氨酶)、AST(谷草转氨酶)、PLT(血小板)等指标,根据病理肝纤维化分期设定两个判定点,分别为显著...目的探讨FIB-4(fibrosis index based on the 4 factor)指数对慢性乙型肝炎患者肝纤维化诊断价值。方法检测86例慢性乙肝患者血清ALT(谷丙转氨酶)、AST(谷草转氨酶)、PLT(血小板)等指标,根据病理肝纤维化分期设定两个判定点,分别为显著纤维化(≥S2级)和肝硬化(S4级),采用FIB-4指数加以评分,以肝组织病理学检查作对比,根据受试者工作特征曲线(AU-ROCs)评价FIB-4对于肝纤维化的诊断价值。结果FIB-4指数采用AUROCs加以评价,显示FIB-4≥S2级(显著纤维化)AUC曲线下面积为0.813,以1.56分值为界值,诊断显著肝纤维化敏感性、特异性、PPV和NPV分别达到86.21%、71.43%、86.2%和71.4%。S4级(肝硬化)AUC曲线下面积为0.802,以2.2分值为界值,诊断肝硬化敏感性、特异性、PPV和NPV分别达到87.5%、67.14%、37.8%和95.9%。结论FIB-4指数是一种简单易行、预测结果可靠的非侵入诊断方法,在一定程度上可替代肝活检。展开更多
文摘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 (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<sup>®</sup> 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%).
文摘Hepatitis C infection in people living with Human Immunodeficiency Virus (HIV) poses management challenges. Of the world’s population, 3% are estimated to have chronic Hepatitis C Virus (HCV) infection, which is responsible for about 70% of cases of chronic hepatitis (accelerated chronicity in the presence of HIV and for such major complications as cirrhosis and hepatocellular carcinoma. The fibrosis 4 (FIB-4) and Aspartate aminotransferase/platelet ratio index (APRI) scores are simple, inexpensive tests accessible to most people, and their performance has not yet been studied in C?te d’Ivoire. Objective: To prospectively evaluate the diagnostic performance of APRI and FIB-4 scores in liver damage in those co-infected with HIV/HCV in C?te d’Ivoire. Methods: This study was conducted over three months. The patients came from national blood transfusion center of the cities of Man and Daloa. The criteria for selecting respondents were at least 18 years of age and a positive test for HIV and HCV. APRI and FIB-4 scores were calculated for each patient from biological data obtained by COBAS C311 (Roche Hitachi, Japan). Statistical analyses were performed using GraphPad and MED-CALC software. Results: Our study involved 30 patients (men) of middle age (25 - 52 years), with extremes ranging from 0.67 to 8 for APRI and 0.201 to 22 for FIB-4. A predictive APRI and FIB4 score of significant hepatic fibrosis was observed in 23% of patients;however, 46% and 54% of patients for the APRI and FIB-4 score, respectively, would not have significant fibrosis. An APRI and FIB4 score not included in the classification limits of the type of fibrosis hepatitis was observed in 31% and 23% of patients, respectively. Conclusion: The performance of the APRI and FIB-4 biological scores analyzed according to the interpretation of their cut-off values would enable classifying about 70% and 77%, respectively, of the patient population in the stages of hepatitis C fibrosis.
文摘目的探讨FIB-4(fibrosis index based on the 4 factor)指数对慢性乙型肝炎患者肝纤维化诊断价值。方法检测86例慢性乙肝患者血清ALT(谷丙转氨酶)、AST(谷草转氨酶)、PLT(血小板)等指标,根据病理肝纤维化分期设定两个判定点,分别为显著纤维化(≥S2级)和肝硬化(S4级),采用FIB-4指数加以评分,以肝组织病理学检查作对比,根据受试者工作特征曲线(AU-ROCs)评价FIB-4对于肝纤维化的诊断价值。结果FIB-4指数采用AUROCs加以评价,显示FIB-4≥S2级(显著纤维化)AUC曲线下面积为0.813,以1.56分值为界值,诊断显著肝纤维化敏感性、特异性、PPV和NPV分别达到86.21%、71.43%、86.2%和71.4%。S4级(肝硬化)AUC曲线下面积为0.802,以2.2分值为界值,诊断肝硬化敏感性、特异性、PPV和NPV分别达到87.5%、67.14%、37.8%和95.9%。结论FIB-4指数是一种简单易行、预测结果可靠的非侵入诊断方法,在一定程度上可替代肝活检。
