Evaluation of APRI combined with FIB-4 index for diagnosing liver cirrhosis in patients with chronic hepatitis B

Objective To investigate the diagnostic value of aspartate transaminase (AST) to platelet (PLT) ratio index (APRI) combined with age-AST-PLT-alanine aminotransferase (ALT) related ratio fibrosis-4 (FIB-4) index for liver cirrhosis in patients with hepatitis B e antigen (HBeAg) positive and negative chronic hepatitis B (CHB). Methods A total of 768 CHB patients who were first treated in Huai'an No.4 People's Hospital from February 2019 to December 2022 were selected. After screening, 507 patients were enrolled, including 71 HBeAg positive patients, 436 HBeAg negative patients and 88 liver cirrhosis patients. Their clinical data, pathological data of liver puncture and routine laboratory indexes were recorded when the patients were enrolled. APRI and FIB-4 indexes were calculated according to the formula, and their correlation with liver cirrhosis was analyzed. A receiver operating characteristic (ROC) curve was plotted to compare the diagnostic value of APRI, FIB-4 and combined indexes for HBeAg positive/negative CHB-related liver cirrhosis. Univariate and multivariate logistic regression analysis were performed to determine the independent risk factors of liver cirrhosis. Results The male to female ratio of enrolled CHB patients was 343∶164, and HBeAg negative patients were older, but the proportion of liver cirrhosis was higher in HBeAg-positive patients. APRI was an independent risk factor for HBeAg-positive/negative cirrhosis, and FIB-4 for HBeAg-negative cirrhosis. The area under the ROC curve (AUC) of FIB-4 was less than the APRI. The AUC values of combined APRI and FIB-4 in the HBeAg positive/negative group were 0.79 and 0.69, respectively. Therefore, the combination of APRI and Fib-4 was more effective in the diagnosis of liver cirrhosis. The optimal cut-off values of APRI and FIB-4 for diagnosis of liver cirrhosis in HBeAg positive and HBeAg negative patients were 0.53 and 0.47, and 1.53 and 1.59, respectively. Conclusions APRI combined with FIB-4 index can be used as a useful diagnostic indicator for liver cirrhosis in CHB patients.