Profile and value of FIB-4 in patients with dual chronic hepatitis C and B
Journal
Journal of Gastroenterology and Hepatology (Australia)
Journal Volume
34
Journal Issue
2
Pages
410-417
Date Issued
2019
Author(s)
Abstract
Background and Aims: Patients with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection are at risk of developing adverse outcomes. Coinfection with both viruses may further increase the risk. Currently, little is known about the role of fibrosis-4 (FIB-4) index, a simple liver fibrosis stage biomarker, in predicting the clinical outcomes. Methods: We retrospectively enrolled 152 non-cirrhotic patients with dual chronic HCV and HBV infection: 56 patients received pegylated interferon/ribavirin therapy, while 96 patients remained untreated. The association between the FIB-4 index and the incidence of liver cirrhosis and hepatocellular carcinoma (HCC) was explored. Results: After a 9.88-year follow-up, the incidence of hepatitis B surface antigen seroclearance was 4.97 (95% confidence interval: 3.13–7.89) per 100 person-years in the treated group and was 1.77 (1.10–2.85) in the untreated group. Of the treated group, only three and six patients developed HCC and liver cirrhosis, respectively, while 17 and 23 patients developed HCC and liver cirrhosis, respectively, in untreated group. Baseline FIB-4 index correlated with the development of liver cirrhosis in multivariable analysis of all subjects. High baseline FIB-4 index (per 1 point increase) in the treated groups was associated with a higher risk of developing liver cirrhosis (P?=?0.001) and HCC (P?=?0.038) in univariable analysis. FIB-4 index decreased only in the treated group who achieved sustained virological response (n?=?34, FIB-4 index decreasing from 1.84 to 1.55). Conclusions: In Taiwanese patients coinfected with HCV and HBV, FIB-4 index helps identify patients at risk of developing adverse events, even in patients receiving pegylated interferon/ribavirin therapy. ? 2018 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd
SDGs
Other Subjects
alanine aminotransferase; hepatitis B surface antigen; hepatitis B(e) antibody; hepatitis B(e) antigen; hepatitis C antibody; peginterferon; ribavirin; virus DNA; virus RNA; adult; alanine aminotransferase blood level; antiviral therapy; Article; chronic hepatitis B; chronic hepatitis C; clinical outcome; cohort analysis; combination drug therapy; digestive system disease assessment; female; Fibrosis 4 Index; follow up; Hepatitis B virus genotype B; Hepatitis B virus genotype C; Hepatitis C virus genotype 1; Hepatitis C virus genotype 2; human; liver cell carcinoma; liver cirrhosis; major clinical study; male; middle aged; mixed infection; nonhuman; priority journal; reference value; retrospective study; risk factor; sustained virologic response
Publisher
Blackwell Publishing
Type
journal article