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KMID : 0882420100780010068
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Korean Journal of Medicine
2010 Volume.78 No. 1 p.68 ~ p.74
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The prevalence of significant fibrosis in chronic hepatitis B patients with ALT <80 IU/L
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Lee Woo-Jin
Park Seung-Ha
Kim Dong-Joon
Lee Sung-Hoa
Lee Chan-Woo
Park Kyu-Tae
Cheong Jae-Youn
Cho Sung-Won
Hwang Seong-Gyu
Lee Youn-Jae
Cho Mong
Yang Jin-Mo
Kim Young-Bae
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Abstract
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Background/Aims: The aims of this study were to investigate the prevalence of significant fibrosis in patients with chronic hepatitis B (CHB) virus infections and alanine aminotransferase (ALT) <80 IU/L, and to develop a noninvasive predictive model for significant fibrosis.
Methods: The 136 patients with CHB who underwent liver biopsy were recruited from six tertiary hospitals. The diagnostic value of predictors was judged using multivariate logistic modeling and the area under the receiver operating characteristic (AUROC) curve.
Results: Significant fibrosis was diagnosed in 97 patients (71.3%, 95% CI, 63.7~78.9%). In the training set (n = 85), the most important clinical data for predicting significant fibrosis were age and aspartate aminotransferase (AST). The AUROC of this model was 0.86 (95% CI, 0.78~0.94). The validation set (n=51), obtained from another institute, yielded similar results [AUROC: 0.90 (95% CI, 0.78~0.99)].
Conclusions: A high prevalence of significant fibrosis in CHB patients with ALT <80 IU/L was observed. A simple model that includes age and AST provides an easily applicable tool for physicians to guide the decision-making process regarding the need to perform a liver biopsy in individual patients. However, additional studies are needed to explore the model’s performance in larger, independent patient populations. (Korean J Med 78:68-74, 2010)
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KEYWORD
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Hepatitis B, chronic, Fibrosis, Prediction, Model
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