Noninvasive Markers of Liver Fibrosis and Inflammation in Chronic Hepatitis B-Vi

[Guest guest]

The American Journal of Gastroenterology

Volume 101 Page 2537 - November 2006

doi:10.1111/j.1572-0241.2006.00788.x

Volume 101 Issue 11

Noninvasive Markers of Liver Fibrosis and Inflammation in Chronic Hepatitis

B-Virus Related Liver Disease

Mehdi Mohamadnejad, M.D.1,2, Ghodrat Montazeri, M.D.1, Atoosa Fazlollahi,

M.D.1, Farhad Zamani, M.D.2, Jafar Nasiri, M.D.1, Hossein Nobakht, M.D.1,

Mohammad Hossein Forouzanfar, M.D.3, Shifteh Abedian, M.D.1, Seyed Mohamad

Tavangar, M.D.4, Ashraf Mohamadkhani, M.D.1, Farhad Ghoujeghi, M.Sc.1,

Arezoo Estakhri, M.D.1, Negin Nouri, M.D.1, Zahra Farzadi, M.D.1, Abolfazl

Najjari, M.D.2, and Reza Malekzadeh, M.D.1

BACKGROUND/AIMS: Noninvasive markers for predicting significant fibrosis

and inflammation have not yet been validated in an unselected group of

chronic hepatitis B virus (HBV) carriers. The aim of this study was to

create noninvasive models to predict significant fibrosis and inflammation

in chronic HBV carriers.

METHODS: A total of 276 (229 HBeAg negative, 47 HBeAg positive) unselected

consecutive treatment naïve patients chronically infected with HBV who

attended our center over a 36-month period underwent liver biopsy. HBeAg

negative patients were randomly divided into two cohorts: training group (N

= 130) and validation group (N = 99). HBeAg positive patients were analyzed

as a whole without separation. Thirteen parameters were analyzed separately

in HBeAg negative and HBeAg positive patients to predict significant

fibrosis (Ishak stage & #8805;3) and inflammation (Ishak grade & #8805;7).

RESULTS: In HBeAg negative patients significant liver fibrosis was best

predicted using the variables HBV DNA levels, alkaline phosphatase, albumin,

and platelet counts with an area under ROC curve (AUC) of 0.91 for the

training group and 0.85 for the validation group. Using the low cutoff

probability of 4.72, significant fibrosis could be excluded with negative

predictive value of 99% in the entire cohort, and liver biopsy would have

been avoided in 52% of patients. The best model for predicting significant

inflammation included the variables age, HBV DNA levels, AST, and albumin

with an AUC of 0.93 in the training and 0.82 in the validation group. In

HBeAg positive patients no factor could predict accurately stages of liver

fibrosis, but the best factor for predicting significant inflammation was

AST with an AUC of 0.87.

CONCLUSIONS: Significant hepatic fibrosis and necroinflammation can

reliably be predicted using routinely checked tests and HBV DNA levels.

(Am J Gastroenterol 2006;101:2537–2545)

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1572-0241.2006.00788.x

_________________________________________________________________

Find a local pizza place, music store, museum and more…then map the best

route! http://local.live.com?FORM=MGA001

[Guest guest]

The American Journal of Gastroenterology

Volume 101 Page 2537 - November 2006

doi:10.1111/j.1572-0241.2006.00788.x

Volume 101 Issue 11

Noninvasive Markers of Liver Fibrosis and Inflammation in Chronic Hepatitis

B-Virus Related Liver Disease

Mehdi Mohamadnejad, M.D.1,2, Ghodrat Montazeri, M.D.1, Atoosa Fazlollahi,

M.D.1, Farhad Zamani, M.D.2, Jafar Nasiri, M.D.1, Hossein Nobakht, M.D.1,

Mohammad Hossein Forouzanfar, M.D.3, Shifteh Abedian, M.D.1, Seyed Mohamad

Tavangar, M.D.4, Ashraf Mohamadkhani, M.D.1, Farhad Ghoujeghi, M.Sc.1,

Arezoo Estakhri, M.D.1, Negin Nouri, M.D.1, Zahra Farzadi, M.D.1, Abolfazl

Najjari, M.D.2, and Reza Malekzadeh, M.D.1

BACKGROUND/AIMS: Noninvasive markers for predicting significant fibrosis

and inflammation have not yet been validated in an unselected group of

chronic hepatitis B virus (HBV) carriers. The aim of this study was to

create noninvasive models to predict significant fibrosis and inflammation

in chronic HBV carriers.

METHODS: A total of 276 (229 HBeAg negative, 47 HBeAg positive) unselected

consecutive treatment naïve patients chronically infected with HBV who

attended our center over a 36-month period underwent liver biopsy. HBeAg

negative patients were randomly divided into two cohorts: training group (N

= 130) and validation group (N = 99). HBeAg positive patients were analyzed

as a whole without separation. Thirteen parameters were analyzed separately

in HBeAg negative and HBeAg positive patients to predict significant

fibrosis (Ishak stage & #8805;3) and inflammation (Ishak grade & #8805;7).

RESULTS: In HBeAg negative patients significant liver fibrosis was best

predicted using the variables HBV DNA levels, alkaline phosphatase, albumin,

and platelet counts with an area under ROC curve (AUC) of 0.91 for the

training group and 0.85 for the validation group. Using the low cutoff

probability of 4.72, significant fibrosis could be excluded with negative

predictive value of 99% in the entire cohort, and liver biopsy would have

been avoided in 52% of patients. The best model for predicting significant

inflammation included the variables age, HBV DNA levels, AST, and albumin

with an AUC of 0.93 in the training and 0.82 in the validation group. In

HBeAg positive patients no factor could predict accurately stages of liver

fibrosis, but the best factor for predicting significant inflammation was

AST with an AUC of 0.87.

CONCLUSIONS: Significant hepatic fibrosis and necroinflammation can

reliably be predicted using routinely checked tests and HBV DNA levels.

(Am J Gastroenterol 2006;101:2537–2545)

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1572-0241.2006.00788.x

_________________________________________________________________

Find a local pizza place, music store, museum and more…then map the best

route! http://local.live.com?FORM=MGA001

[Guest guest]

The American Journal of Gastroenterology

Volume 101 Page 2537 - November 2006

doi:10.1111/j.1572-0241.2006.00788.x

Volume 101 Issue 11

Noninvasive Markers of Liver Fibrosis and Inflammation in Chronic Hepatitis

B-Virus Related Liver Disease

Mehdi Mohamadnejad, M.D.1,2, Ghodrat Montazeri, M.D.1, Atoosa Fazlollahi,

M.D.1, Farhad Zamani, M.D.2, Jafar Nasiri, M.D.1, Hossein Nobakht, M.D.1,

Mohammad Hossein Forouzanfar, M.D.3, Shifteh Abedian, M.D.1, Seyed Mohamad

Tavangar, M.D.4, Ashraf Mohamadkhani, M.D.1, Farhad Ghoujeghi, M.Sc.1,

Arezoo Estakhri, M.D.1, Negin Nouri, M.D.1, Zahra Farzadi, M.D.1, Abolfazl

Najjari, M.D.2, and Reza Malekzadeh, M.D.1

BACKGROUND/AIMS: Noninvasive markers for predicting significant fibrosis

and inflammation have not yet been validated in an unselected group of

chronic hepatitis B virus (HBV) carriers. The aim of this study was to

create noninvasive models to predict significant fibrosis and inflammation

in chronic HBV carriers.

METHODS: A total of 276 (229 HBeAg negative, 47 HBeAg positive) unselected

consecutive treatment naïve patients chronically infected with HBV who

attended our center over a 36-month period underwent liver biopsy. HBeAg

negative patients were randomly divided into two cohorts: training group (N

= 130) and validation group (N = 99). HBeAg positive patients were analyzed

as a whole without separation. Thirteen parameters were analyzed separately

in HBeAg negative and HBeAg positive patients to predict significant

fibrosis (Ishak stage & #8805;3) and inflammation (Ishak grade & #8805;7).

RESULTS: In HBeAg negative patients significant liver fibrosis was best

predicted using the variables HBV DNA levels, alkaline phosphatase, albumin,

and platelet counts with an area under ROC curve (AUC) of 0.91 for the

training group and 0.85 for the validation group. Using the low cutoff

probability of 4.72, significant fibrosis could be excluded with negative

predictive value of 99% in the entire cohort, and liver biopsy would have

been avoided in 52% of patients. The best model for predicting significant

inflammation included the variables age, HBV DNA levels, AST, and albumin

with an AUC of 0.93 in the training and 0.82 in the validation group. In

HBeAg positive patients no factor could predict accurately stages of liver

fibrosis, but the best factor for predicting significant inflammation was

AST with an AUC of 0.87.

CONCLUSIONS: Significant hepatic fibrosis and necroinflammation can

reliably be predicted using routinely checked tests and HBV DNA levels.

(Am J Gastroenterol 2006;101:2537–2545)

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1572-0241.2006.00788.x

_________________________________________________________________

Find a local pizza place, music store, museum and more…then map the best

route! http://local.live.com?FORM=MGA001

[Guest guest]

The American Journal of Gastroenterology

Volume 101 Page 2537 - November 2006

doi:10.1111/j.1572-0241.2006.00788.x

Volume 101 Issue 11

Noninvasive Markers of Liver Fibrosis and Inflammation in Chronic Hepatitis

B-Virus Related Liver Disease

Mehdi Mohamadnejad, M.D.1,2, Ghodrat Montazeri, M.D.1, Atoosa Fazlollahi,

M.D.1, Farhad Zamani, M.D.2, Jafar Nasiri, M.D.1, Hossein Nobakht, M.D.1,

Mohammad Hossein Forouzanfar, M.D.3, Shifteh Abedian, M.D.1, Seyed Mohamad

Tavangar, M.D.4, Ashraf Mohamadkhani, M.D.1, Farhad Ghoujeghi, M.Sc.1,

Arezoo Estakhri, M.D.1, Negin Nouri, M.D.1, Zahra Farzadi, M.D.1, Abolfazl

Najjari, M.D.2, and Reza Malekzadeh, M.D.1

BACKGROUND/AIMS: Noninvasive markers for predicting significant fibrosis

and inflammation have not yet been validated in an unselected group of

chronic hepatitis B virus (HBV) carriers. The aim of this study was to

create noninvasive models to predict significant fibrosis and inflammation

in chronic HBV carriers.

METHODS: A total of 276 (229 HBeAg negative, 47 HBeAg positive) unselected

consecutive treatment naïve patients chronically infected with HBV who

attended our center over a 36-month period underwent liver biopsy. HBeAg

negative patients were randomly divided into two cohorts: training group (N

= 130) and validation group (N = 99). HBeAg positive patients were analyzed

as a whole without separation. Thirteen parameters were analyzed separately

in HBeAg negative and HBeAg positive patients to predict significant

fibrosis (Ishak stage & #8805;3) and inflammation (Ishak grade & #8805;7).

RESULTS: In HBeAg negative patients significant liver fibrosis was best

predicted using the variables HBV DNA levels, alkaline phosphatase, albumin,

and platelet counts with an area under ROC curve (AUC) of 0.91 for the

training group and 0.85 for the validation group. Using the low cutoff

probability of 4.72, significant fibrosis could be excluded with negative

predictive value of 99% in the entire cohort, and liver biopsy would have

been avoided in 52% of patients. The best model for predicting significant

inflammation included the variables age, HBV DNA levels, AST, and albumin

with an AUC of 0.93 in the training and 0.82 in the validation group. In

HBeAg positive patients no factor could predict accurately stages of liver

fibrosis, but the best factor for predicting significant inflammation was

AST with an AUC of 0.87.

CONCLUSIONS: Significant hepatic fibrosis and necroinflammation can

reliably be predicted using routinely checked tests and HBV DNA levels.

(Am J Gastroenterol 2006;101:2537–2545)

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1572-0241.2006.00788.x

_________________________________________________________________

Find a local pizza place, music store, museum and more…then map the best

route! http://local.live.com?FORM=MGA001