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Article: A new model using routinely available clinical parameters to predict significant liver fibrosis in chronic hepatitis B

TitleA new model using routinely available clinical parameters to predict significant liver fibrosis in chronic hepatitis B
Authors
Issue Date2011
PublisherPublic Library of Science. The Journal's web site is located at http://www.plosone.org/home.action
Citation
Plos One, 2011, v. 6 n. 8 How to Cite?
AbstractObjective: We developed a predictive model for significant fibrosis in chronic hepatitis B (CHB) based on routinely available clinical parameters. Methods: 237 treatment-naïve CHB patients [58.4% hepatitis B e antigen (HBeAg)-positive] who had undergone liver biopsy were randomly divided into two cohorts: training group (n = 108) and validation group (n = 129). Liver histology was assessed for fibrosis. All common demographics, viral serology, viral load and liver biochemistry were analyzed. Results: Based on 12 available clinical parameters (age, sex, HBeAg status, HBV DNA, platelet, albumin, bilirubin, ALT, AST, ALP, GGT and AFP), a model to predict significant liver fibrosis (Ishak fibrosis score ≥3) was derived using the five best parameters (age, ALP, AST, AFP and platelet). Using the formula log(index+1) = 0.025+0.0031(age)+0.1483 log(ALP)+0.004 log(AST)+0.0908 log(AFP+1)-0.028 log(platelet), the PAPAS (Platelet/Age/Phosphatase/AFP/AST) index predicts significant fibrosis with an area under the receiving operating characteristics (AUROC) curve of 0.776 [0.797 for patients with ALT <2×upper limit of normal (ULN)] The negative predictive value to exclude significant fibrosis was 88.4%. This predictive power is superior to other non-invasive models using common parameters, including the AST/platelet/GGT/AFP (APGA) index, AST/platelet ratio index (APRI), and the FIB-4 index (AUROC of 0.757, 0.708 and 0.723 respectively). Using the PAPAS index, 67.5% of liver biopsies for patients being considered for treatment with ALT <2×ULN could be avoided. Conclusion: The PAPAS index can predict and exclude significant fibrosis, and may reduce the need for liver biopsy in CHB patients. © 2011 Seto et al.
Persistent Identifierhttp://hdl.handle.net/10722/142388
ISSN
2015 Impact Factor: 3.057
2015 SCImago Journal Rankings: 1.395
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorSeto, WKen_HK
dc.contributor.authorLee, CFen_HK
dc.contributor.authorLai, CLen_HK
dc.contributor.authorIp, PPCen_HK
dc.contributor.authorFong, YTen_HK
dc.contributor.authorFung, Jen_HK
dc.contributor.authorWong, KHen_HK
dc.contributor.authorYuen, MFen_HK
dc.date.accessioned2011-10-28T02:44:55Z-
dc.date.available2011-10-28T02:44:55Z-
dc.date.issued2011en_HK
dc.identifier.citationPlos One, 2011, v. 6 n. 8en_HK
dc.identifier.issn1932-6203en_HK
dc.identifier.urihttp://hdl.handle.net/10722/142388-
dc.description.abstractObjective: We developed a predictive model for significant fibrosis in chronic hepatitis B (CHB) based on routinely available clinical parameters. Methods: 237 treatment-naïve CHB patients [58.4% hepatitis B e antigen (HBeAg)-positive] who had undergone liver biopsy were randomly divided into two cohorts: training group (n = 108) and validation group (n = 129). Liver histology was assessed for fibrosis. All common demographics, viral serology, viral load and liver biochemistry were analyzed. Results: Based on 12 available clinical parameters (age, sex, HBeAg status, HBV DNA, platelet, albumin, bilirubin, ALT, AST, ALP, GGT and AFP), a model to predict significant liver fibrosis (Ishak fibrosis score ≥3) was derived using the five best parameters (age, ALP, AST, AFP and platelet). Using the formula log(index+1) = 0.025+0.0031(age)+0.1483 log(ALP)+0.004 log(AST)+0.0908 log(AFP+1)-0.028 log(platelet), the PAPAS (Platelet/Age/Phosphatase/AFP/AST) index predicts significant fibrosis with an area under the receiving operating characteristics (AUROC) curve of 0.776 [0.797 for patients with ALT <2×upper limit of normal (ULN)] The negative predictive value to exclude significant fibrosis was 88.4%. This predictive power is superior to other non-invasive models using common parameters, including the AST/platelet/GGT/AFP (APGA) index, AST/platelet ratio index (APRI), and the FIB-4 index (AUROC of 0.757, 0.708 and 0.723 respectively). Using the PAPAS index, 67.5% of liver biopsies for patients being considered for treatment with ALT <2×ULN could be avoided. Conclusion: The PAPAS index can predict and exclude significant fibrosis, and may reduce the need for liver biopsy in CHB patients. © 2011 Seto et al.en_HK
dc.languageengen_US
dc.publisherPublic Library of Science. The Journal's web site is located at http://www.plosone.org/home.actionen_HK
dc.relation.ispartofPLoS ONEen_HK
dc.subject.meshHepatitis B, Chronic - complications - diagnosis-
dc.subject.meshLiver Cirrhosis - complications - diagnosis-
dc.subject.meshModels, Biological-
dc.subject.meshPredictive Value of Tests-
dc.subject.meshReproducibility of Results-
dc.titleA new model using routinely available clinical parameters to predict significant liver fibrosis in chronic hepatitis Ben_HK
dc.typeArticleen_HK
dc.identifier.emailSeto, WK: wkseto2@hku.hken_HK
dc.identifier.emailLai, CL: hrmelcl@hku.hken_HK
dc.identifier.emailFong, YT: dytfong@hku.hken_HK
dc.identifier.emailFung, J: jfung@sicklehut.comen_HK
dc.identifier.emailWong, KH: danywong@hku.hken_HK
dc.identifier.emailYuen, MF: mfyuen@hku.hken_HK
dc.identifier.authoritySeto, WK=rp01659en_HK
dc.identifier.authorityLai, CL=rp00314en_HK
dc.identifier.authorityFong, YT=rp00253en_HK
dc.identifier.authorityFung, J=rp00518en_HK
dc.identifier.authorityWong, KH=rp00492en_HK
dc.identifier.authorityYuen, MF=rp00479en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1371/journal.pone.0023077en_HK
dc.identifier.pmid21853071-
dc.identifier.pmcidPMC3154931-
dc.identifier.scopuseid_2-s2.0-80051604371en_HK
dc.identifier.hkuros196658en_US
dc.identifier.hkuros213690-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-80051604371&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume6en_HK
dc.identifier.issue8en_HK
dc.identifier.spagee23077en_US
dc.identifier.epagee23077en_US
dc.identifier.isiWOS:000293953400025-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridSeto, WK=23390675900en_HK
dc.identifier.scopusauthoridLee, CF=49661724900en_HK
dc.identifier.scopusauthoridLai, CL=7403086396en_HK
dc.identifier.scopusauthoridIp, PPC=7003622683en_HK
dc.identifier.scopusauthoridFong, YT=35261710300en_HK
dc.identifier.scopusauthoridFung, J=23091109300en_HK
dc.identifier.scopusauthoridWong, KH=7401535819en_HK
dc.identifier.scopusauthoridYuen, MF=7102031955en_HK

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