Objective: To confirm the diagnostic value of FibroTest-ActiTest (FT-AT) in predicting liver fibrosis and inflammatory activity in patients with chronic hepatitis B (CHB), and to study the discordances between FT and their liver biopsies.
Methods: A study was performed on 100 patients with CHB who underwent liver biopsies in our hospital. Serum samples for biochemical markers were taken on the day of their biopsies. Diagnostic accuracies were assessed by ROC curve analysis.
Results: The median biopsy specimen size was 15 mm (range: 8-30), with 9 (median) portal tracts (range 5-26). Thirty-nine patients were classified as Ishak F3-F6 in fibrosis and 65 patients as A2-A4 in inflammation. Areas under ROC curve for diagnosis of significant inflammation (A2-A4), significant fibrosis (F3-F6), and cirrhosis (F5-F6) were 0.833 (95% CI: 0.753-0.913), 0.840 (0.750-0.929), and 0.862 (0.721-1.003), respectively. FT less than 0.31 had a NPV of 86% for excluding significant fibrosis, whereas FT > or = 0.72 had a PPV of 92% for predicting significant fibrosis. Among the 26 patients with 2 fibrosis stages of discordances between FT and biopsy, the discordance was attributable to biopsy in 3 cases, to FT in 7, and undetermined in 16.
Conclusion: This study confirms the diagnostic value of FT-AT and suggests that 68% of our patients with CHB can be reliably identified by FT without a liver biopsy and with a diagnosis accuracy of 87%.