The accuracy of the FIB-4 index for the diagnosis of mild fibrosis in chronic hepatitis B

[Guest guest]

http://www3.interscience.wiley.com/journal/121524286/abstract?CRETRY=1 & SRETRY=0

Alimentary Pharmacology & Therapeutics

Volume 29 Issue 4, Pages 409 - 415

Published Online: 19 Nov 2008

2006 The Authors Journal compilation 2006 Blackwell Publishing Ltd

The accuracy of the FIB-4 index for the diagnosis of mild fibrosis in chronic

hepatitis B

V. MALLET*,†,‡,1, V. DHALLUIN-VENIER*,†,1, C. ROUSSIN§, M. BOURLIERE¶,

M. E. PETTINELLI**, C. GIRY**, A. VALLET-PICHARD*,†,‡, H. FONTAINE†,‡ &

S. POL*,†,‡

*Université Paris Descartes, Paris, France ; †Assistance Publique

Hôpitaux de Paris, Hôpital Cochin, Hépatologie, Paris, France ; ‡INSERM

U. 567, Paris, France ; §Centre Hospitalier de Mayotte, Unité de Médecine,

Mayotte, France ; ¶Hôpital Saint ph, Hépato-gastroentérologie,

Marseilles, France ; **Centre Hospitalier de Mayotte, Laboratoire de Biologie,

Mayotte, France

Correspondence to Dr V. Mallet, Hépatologie, Hôpital Cochin, 27 rue du

faubourg Saint Jacques, 75014 Paris, France.

E-mail: vincent.mallet@...

1 Contributed equally to this work.

ABSTRACT

Background The Fib-4 index is a simple and inexpensive biomarker to delineate

liver fibrosis in chronic hepatitis C.

Aim To assess the accuracy of the FIB-4 index in chronic hepatitis B.

Methods We compared the FIB-4 index with 138 synchronous liver biopsies and with

372 synchronous FibroTest performed either in France or in an endemic area

(Mayotte, an overseas collectivity of France).

Results The FIB-4 index allowed the correct identification of patients with

nil-to-moderate fibrosis with an area under the receiving operating

characteristic curve of 0.81 (P < 0.001), increasing as a function of the length

of the liver biopsy (up to 0.94 for liver biopsies ≥20 mm). A cut-off value

≤1.45 differentiated moderate fibrosis from severe fibrosis with a negative

predictive value of 86%, a sensitivity of 71.1% and a specificity of 73.1%.

Beyond 1.45, the FIB-4 index was not informative. The FIB-4 index was more

precise than the AST-to-platelet ratio index and correlated with the FibroTest

in 89% of the cases (κ = 0.27, P < 0.001) to exclude severe fibrosis.

Conclusion The FIB-4 index is a simple, accurate and inexpensive method to

exclude significant liver fibrosis in chronic hepatitis B, a major advantage in

HBV-endemic developing countries.

--------------------------------------------------------------------------------

Publication data Submitted 5 May 2008 First decision 21 May 2008 Resubmitted 30

September 2008 Accepted 11 November 2008 Epub Accepted Article 19 November 2008

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1365-2036.2008.03895.x

[Guest guest]

http://www3.interscience.wiley.com/journal/121524286/abstract?CRETRY=1 & SRETRY=0

Alimentary Pharmacology & Therapeutics

Volume 29 Issue 4, Pages 409 - 415

Published Online: 19 Nov 2008

2006 The Authors Journal compilation 2006 Blackwell Publishing Ltd

The accuracy of the FIB-4 index for the diagnosis of mild fibrosis in chronic

hepatitis B

V. MALLET*,†,‡,1, V. DHALLUIN-VENIER*,†,1, C. ROUSSIN§, M. BOURLIERE¶,

M. E. PETTINELLI**, C. GIRY**, A. VALLET-PICHARD*,†,‡, H. FONTAINE†,‡ &

S. POL*,†,‡

*Université Paris Descartes, Paris, France ; †Assistance Publique

Hôpitaux de Paris, Hôpital Cochin, Hépatologie, Paris, France ; ‡INSERM

U. 567, Paris, France ; §Centre Hospitalier de Mayotte, Unité de Médecine,

Mayotte, France ; ¶Hôpital Saint ph, Hépato-gastroentérologie,

Marseilles, France ; **Centre Hospitalier de Mayotte, Laboratoire de Biologie,

Mayotte, France

Correspondence to Dr V. Mallet, Hépatologie, Hôpital Cochin, 27 rue du

faubourg Saint Jacques, 75014 Paris, France.

E-mail: vincent.mallet@...

1 Contributed equally to this work.

ABSTRACT

Background The Fib-4 index is a simple and inexpensive biomarker to delineate

liver fibrosis in chronic hepatitis C.

Aim To assess the accuracy of the FIB-4 index in chronic hepatitis B.

Methods We compared the FIB-4 index with 138 synchronous liver biopsies and with

372 synchronous FibroTest performed either in France or in an endemic area

(Mayotte, an overseas collectivity of France).

Results The FIB-4 index allowed the correct identification of patients with

nil-to-moderate fibrosis with an area under the receiving operating

characteristic curve of 0.81 (P < 0.001), increasing as a function of the length

of the liver biopsy (up to 0.94 for liver biopsies ≥20 mm). A cut-off value

≤1.45 differentiated moderate fibrosis from severe fibrosis with a negative

predictive value of 86%, a sensitivity of 71.1% and a specificity of 73.1%.

Beyond 1.45, the FIB-4 index was not informative. The FIB-4 index was more

precise than the AST-to-platelet ratio index and correlated with the FibroTest

in 89% of the cases (κ = 0.27, P < 0.001) to exclude severe fibrosis.

Conclusion The FIB-4 index is a simple, accurate and inexpensive method to

exclude significant liver fibrosis in chronic hepatitis B, a major advantage in

HBV-endemic developing countries.

--------------------------------------------------------------------------------

Publication data Submitted 5 May 2008 First decision 21 May 2008 Resubmitted 30

September 2008 Accepted 11 November 2008 Epub Accepted Article 19 November 2008

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1365-2036.2008.03895.x