NONINVASIVE DIAGNOSIS OF LIVER FIBROSIS IN PATIENTS WITH CHRONIC VIRAL HEPATITIS: COMPARATIVE ASPECT

Defining a stage of liver fibrosis is critical in choosing treatment tactics. The predictive models based on calculation of indirect fibrosis indexes remain relevant. A research objective was to compare indirect noninvasive methods of liver fibrosis diagnosis in patients with chronic viral hepatitis in Yakutia. The research covered 140 patients with chronic viral hepatitis: 77 women (55%) and 63 men (45%) aged 21-55 years (average age of 45.78±14.92 years). The severity of fibrosis was estimated by the APRI scale. We analyzed the data from biochemical tests, general blood test and coagulogramm. APRI detected stage F1 in 7 (5%), stage F2 in 23 (16.4%), stage F3 and F4 in 34 (24.3%) and 76 (54.3%), respectively, CVH patients. Three groups of patients were created: with initial fibrosis (F1/2, n = 30), widespread fibrosis (F3, n = 34), and the fibrosis that transformed into cirrhosis (F4, n = 76). In the groups of patients with F1/F2, F3 and F4, median FIB-4 values were 2.56 (LQ-UQ 2.22-2.73), 2.73 (2.54-2.94) and 3.57 (3.27-4.11), respectively. The FIB-4 value directly correlated with the APRI index (rS = 0.68; p <0.000001). In F1/F2, F3 and F4 groups, the median Fibrosis Index values were 3.56 (LQ-UQ 3.01-3.88), 3.73 (2.14-4.54) and 4.57 (3.47-4.21), respectively. Fibrosis Index did not coincide with results of APRI, which signals a high (12.7%) frequency of false results. The results of FIB-4 in 136 out of 140 sick HVH patients coincided with the results of the APRI index, which indicates high diagnostic precision. Thus, the offered approach provides high (97%) diagnostic accuracy to estimate severity of fibrosis at patients with chronic viral hepatitis.

FIB4, APRI, liver fibrosis, liver fibrosis index, cirrhosis, liver cirrhosis class, chronic viral hepatitis, FIB4, APRI, prognostic model, coagulogram, general blood test

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