Comparison of invasive and non-invasive tests for assessment of liver fibrosis in the patients with chronic hepatitis B and C

Background: Different methods are used for determining the severity of chronic viral hepatitis and liver fibrosis. Methods: We compared the results of the liver biopsy, based on Metavir scoring system with biomarkers such as Fibrosis-4(FIB-4) and aspartate aminotransferase to platelet ratio index (APRI) in identifying liver fibrosis. Results: Of 194 patients, 63 and 131 had hepatitis B and C, respectively. There was statistically significant difference between Metavir 0/1 and Metavir 2/3 based on FIB-4, APRI and the mean of PT, INR, PLT, ALT and AST. The correlation was seen between FIB-4 and APRI with Metavir score of patients with hepatitis. The liver fibrosis in the patients with hepatitis B according to FIB-4 index in cut off less than 1.1 have sensitivity %83.3, specificity %64.7, positive predictive value (PPV) %35.7 and negative predictive value (NPV) %94.3, but according to APRI in cut off less than 0.73 have the sensitivity %59, specificity %76.5, PPV % 33.3 and NPP %86.7. The liver fibrosis in the patients with hepatitis C according to FIB-4 index in cut off less than 1.47 have sensitivity %73.7, specificity %73.2, PPV %31.8 and NPV %94.3, but according to APRI in cut off less than 1.7 have the sensitivity %42.1, specificity %97.3, PPV % 72.7 and NPP %90.8. Conclusions: According to the results, in the patients with chronic hepatitis, the severity of liver fibrosis increases with rising of APRI and FIB-4 indices. Therefore, these two indices can be used instead of biopsy in certain circumstances.