The Impact Of HBeAg Status On The Diagnostic Performance Of Noninvasive Markers For Fibrosis And Cirrhosis In Patients With Chronic Hepatitis B

Aim:Fibrosis indices,including aspartate transaminase to platelet ratio index(APRI),fibrosis index based on four factors(FIB-4),aspartate aminotransferase/alanine aminotransferase ratio(AAR),AAR/platelet ratio index(AARPRI),and age-platelet(AP)index,have been reported predictive of fibrosis and cirrhosis in patients with chronic hepatitis B(CHB).This study evaluated the impact of HBeAg status on the diagnostic performances of these indices.Methods:This study included 673 patients with CHB.Using Metavir score as a reference,the performances of the APRI,FIB-4,AAR,AARPRI,and AP-index were compared in HBeAg-negative and HBeAg-positive patients.APRI,FIB-4,AARPRI,and AP-index correlated with the degree of liver fibrosis in patients with CHB.Results:The area under the receiver operating characteristic curve(AUROC)was higher for APRI than for FIB-4,AARPRI,and AP-index in predicting significant fibrosis.APRI AUROC was higher in HBeAg-negative than in HBeAg-positive patients,whereas FIB-4 and AARPRI AUROCs were lower in HBeAg-negative than in HBeAg-positive patients,for predicting significant fibrosis and cirrhosis.Using sensitivity≥90%,APRI,FIB-4,and AARPRI cut-offs were higher in HBeAg-negative than in HBeAg-positive patients.Using specificity ≥90%,APRI cut-offs were lower in HBeAg-negative than in HBeAg-positive patients,whereas FIB-4,AARPRI,and AP-index cut-offs were higher in HBeAg-negative than in HBeAg-positive patients,for predicting significant fibrosis and cirrhosis.Conclusion:Evaluations of the diagnostic performances of APRI,FIB-4,AARPRI,and AP-index should consider HBeAg status.