Impact of age on the diagnostic performances and cut-offs of APRI and FIB-4 for significant fibrosis and cirrhosis in chronic hepatitis B

// Qiang Li 1, 2 , Chuan Lu 1 , Weixia Li 1 , Yuxian Huang 1, 2 and Liang Chen 1 1 Department of Hepatitis, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China 2 Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China Correspondence to: Liang Chen, email: chenliang@shaphc.org Qiang Li, email: liqiang66601@163.com Keywords: chronic hepatitis B, liver fibrosis, cirrhosis, noninvasive marker, influence factors Received: March 08, 2017 Accepted: April 15, 2017 Published: April 27, 2017 ABSTRACT Aims: Assessing the diagnostic performances of APRI and FIB-4 using age as a categorical marker. Methods: 822 chronic hepatitis B (CHB) patients were included. Using METAVIR scoring system as a reference, the performances of APRI and FIB-4 were compared between patients aged≥30 and patients aged<30 years. Results: The APRI AUROC in patients aged<30 years was lower than that in patients aged≥30 years for significant fibrosis (0.61 vs 0.70, p <0.001) and cirrhosis (0.64 vs 0.78, p <0.001). The FIB-4 AUROC in patients aged<30 years was lower than that in patients aged≥30 years for significant fibrosis (0.57 vs 0.65, p <0.001) and cirrhosis (0.63 vs 0.72, p <0.001). Using specificity≥90%, the APRI cut-off in patients aged<30 years was lower than patients aged≥30 years for significant fibrosis (1.0 vs 1.2) and cirrhosis (1.2 vs 1.5). Using sensitivity≥90%, the APRI cut-off in patients aged<30 years was also lower than patients aged≥30 years for significant fibrosis (0.2 vs 0.4) and cirrhosis (0.3 vs 0.5). Using specificity≥90%, the FIB-4 cut-off in patients aged<30 years was lower than that in patients aged≥30 years for significant fibrosis (1.2 vs 2.1) and cirrhosis (1.4 vs 2.6). Using sensitivity≥90%, the FIB-4 cut-off in patients aged<30 years was also lower than that in patients aged≥30 years for significant fibrosis (0.5 vs 0.8) and cirrhosis (0.8 vs 1.2). Conclusions: Evaluation of the diagnostic performances of APRI and FIB-4 should take age into consideration.