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Fibrosis‐4 index predicts cirrhosis risk and liver‐related mortality in 2075 patients with chronic HBV infection
Author(s) -
Tseng T.C.,
Liu C.J.,
Su T.H.,
Yang W.T.,
Chen C.L.,
Yang H.C.,
Kuo S. F.T.,
Liu C.H.,
Chen P.J.,
Chen D.S.,
Kao J.H.
Publication year - 2018
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.14619
Subject(s) - medicine , cirrhosis , gastroenterology , hbeag , hazard ratio , hbsag , adverse effect , liver disease , hepatitis b , confidence interval , hepatitis b virus , fibrosis , immunology , virus
Summary Background Fibrosis‐4 index (FIB‐4) is a surrogate marker for hepatic fibrosis in hepatitis B virus (HBV) carriers. Aim To investigate whether FIB‐4 index stratifies the risks of adverse liver events. Methods A total of 2075 treatment‐naïve, noncirrhotic the patients with chronic HBV infection were included. Most of them (82.1%) were HBeAg‐negative patients and their baseline FIB‐4 levels were explored to stratify the risks of cirrhosis, cirrhosis‐related complications and liver‐related mortality. Results During a mean follow‐up period of 15.47 years, we found a higher baseline FIB‐4 index was associated with increased incidence rates of cirrhosis in addition to the common host and viral factors. Patients with FIB‐4 >1.29, compared to those with FIB‐4 <1.29, were associated with increased risks of cirrhosis, cirrhosis‐related complications and liver‐related mortality with the hazard ratio (95% confidence interval) of 6.19 (4.76‐8.05), 6.88, (3.68‐12.86) and 7.79, (4.54‐13.37) respectively. Within the first 3 years of follow‐up, FIB‐4 remained stable and its kinetics were consistently associated with the develoopment of adverse liver events. Furthermore, FIB‐4 index of 1.29 was able to stratify all the risks of adverse liver events even in HBeAg‐negative patients with a low risk of disease progression (HBV DNA <2000 IU/mL, HBsAg <1000 IU/mL and ALT <40 U/L). Only 1 patient with FIB‐4 index <1.29 developed cirrhosis but not other events within 15 years of follow‐up. Conclusions In noncirrhotic patients with chronic HBV infection, a higher FIB‐4 index was associated with increased risks of adverse liver events. FIB‐4 index <1.29 is useful for the prediction of the lowest risks of disease progression.