Abstract:

Objectives: Chronic hepatitis B (CHB) may present with many clinical signs. This study evaluates the CHB cases followed in our center in terms of ELISA, treatment, and non-invasive scoring systems. Materials and Methods: Four hundred CHB cases were retrospectively analyzed. ELISA and treatment status were recorded at the time of diagnosis and at the last admission. Fibrosis-4 (FIB-4) and aspartate aminotransferase - platelet ratio index (APRI) scores were calculated for the cases who underwent biopsy and received treatment (n=40) and for treatment-naive cases without biopsy (n=135). The cut-off values of FIB-4 and APRI were calculated in the groups. The obtained results were compared with the significance of fibrosis markers. The number of patients was determined as a percentage according to the cut-off value calculated for fibrosis ≥2 in FIB-4 and APRI scores in patients who did not undergo biopsy. Results: Of the 400 patients, 52.5% were male. The mean age of the cases was 19.0-84.0 (49±12.7). Hepatitis B surface antigen negativity (p=0.012) developed in nine cases (2.25%) and hepatitis B virus-DNA negativity increased from 7.8% to 63.2% (p=0.001). Of the treatment-naive cases, 36.9% based on the FIB-4 score and 16.3% based on the APRI score were F ≥2. When biopsy was compared with FIB-4 and APRI, the positive predictive value of FIB-4 and APRI scores (87% and 95%, respectively) were found to predict low fibrosis (F ≤1), and negative predictive value NPV (94.7% and 95.8%, respectively) was found to predict advanced fibrosis (F ≥4). Conclusion: The FIB-4 and APRI scores can guide some treatment-naive cases in terms of performing a biopsy and initiating treatment if necessary.

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