Evaluation of the Diagnostic Accuracy of Transient Elastogaraphy and Apri Score in Chronic Hepatitis B (CHB) in a Sample of Iraqi Patients

Hepatitis B is a global chronic disease caused by the hepatitis B virus. Development of liver cirrhosis is one of the most important and serious complication of this infection.

Assess the diagnostic accuracy of transient elastogarphy and AST to platelet ratio index (APRI) score in detecting the degree of liver fibrosis in chronic hepatitis B (CHB) patients, with biopsy samples as a reference standard.

Thirty-seven patients diagnosed as CHB were recruited and the stage of fibrosis was determined by biopsy. The diagnostic accuracy of FibroScan (Echosens, Paris, France) and APRI was evaluated based on the conformity of the results from these tests with those of biopsies. An expert operator performed all measurements. Metavir score was used to assess the degree for liver fibrosis.

The Metavir score for liver biopsies were (F0-F1 N=22, F2 N=12, F3 N=2, and F4=1), while the score assessment by Fibroscan were (F0-F1 N=24, F2 N=10, F3 N=1, and F4=2). There was a significant association between the two groups by the level of assessment method of liver fibrosis (P<0.05). The mean score for APRI, for patients with early degree of liver fibrosis (Metavir Score liver histology F0-F1) (N=22), was 0.58 (SD= 0.417), while those with advanced fibrosis (F3) their mean APRI core was 0.49. Comparing the mean of APRI score results with those of liver histology (ANOVA test), there was no significant association between the two groups (P>0.005).

Transient elastogarphy (FibroScan) has a reliable results in assessing the degree of liver fibrosis in CHB patients. APRI score did not show a significant association with degree of fibrosis in CHB patients.