Noninvasive Tests to Assess Liver Stiffness in Patients with Chronic Hepatitis B: APRI, FIB-4, and FIB-5 Scores

Abstract

Background. Invasive percutaneous liver parenchymal biopsy is the best test used to evaluate liver stiffness and fibrosis in the follow-up and treatment of chronic hepatitis B (CHB) patients. In this study, we aimed to indirectly evaluate the severity of liver parenchymal fibrosis with tests used in the laboratory. Methods. This retrospective study was conducted with 201 patients diagnosed with CHB who underwent liver biopsy between 2021 and 2022. Preprocedural examination information, laboratory tests, and histopathological data of the patients were taken from the hospital database and examined. “Aspartate aminotransferase (AST)-platelet ratio index” (APRI), “4 factor-based fibrosis index” (FIB-4) score, and “5 factor-based fibrosis index” (FIB-5) score were calculated and compared with liver histopathological features. Results. Of the 201 CHB patients, 76 were females and 125 were males. The average age of the patients was 38.05 ± 12.63 years. A weak, statistically significant correlation was observed between FIB-4 and APRI scores. The patients’ significant fibrosis scores were 31.3% and 33.8%, respectively (r = 0.313; r = 0.338; p = 0.001; p < 0.01). The very weak negative correlation of 17.4% between the patients’ FIB-5 score and fibrosis score was statistically significant (r = −0.174; p = 0.014; p < 0.05). Conclusions. According to the data we obtained in our study, while the APRI score and FIB-4 score can be used safely, more comprehensive studies are needed for the reliability of the FIB-5 score.