Changes of FIB-4 index in HBeAg-negative treatment-naive chronic hepatitis B patients receiving 4-year entecavir therapy
10.3760/cma.j.issn.1003-9279.2020.01.011
- VernacularTitle:HBeAg阴性初治慢乙肝患者恩替卡韦4年抗病毒治疗FIB-4评分动态变化研究
- Author:
Ruyu LIU
1
;
Yao LU
;
Ge SHEN
;
Lu ZHANG
;
Shuling WU
;
Min CHANG
;
Leiping HU
;
Hongxiao HAO
;
Yuanjiao GAO
;
Minghui LI
;
Yao XIE
Author Information
1. 首都医科大学附属北京地坛医院肝病二科
- Keywords:
Chronic hepatitis B;
Liver fibrosis;
Entecavir;
FIB-4
- From:
Chinese Journal of Experimental and Clinical Virology
2020;34(1):51-56
- CountryChina
- Language:Chinese
-
Abstract:
Objective Antiviral therapy should be adopted for chronic hepatitis B (CHB) patients with significant liver fibrosis to decrease the risk of liver related complications.Fibrosis assessment during antiviral treatment is a key step in antiviral therapy evaluation.Liver biopsy is the gold standard for assessing the degree of liver fibrosis.However,liver biopsy is difficult to perform more than one time after a long-term effective treatment because of the cost and risk of life-threatening complications.In this study we aimed to evaluate changes of liver fibrosis during 4 years of entecavir(ETV) treatment by non-invasive fibrosis markers in CHB patients who need antiviral therapy.Methods Totally 268 HBeAg negative treatment-naive CHB patients were enrolled and liver biopsy were performed before starting antiviral therapy in this study.Totally173 patients who needed antiviral therapy (liver fibrosis stages≥ F2,Metavir scoring system) were treated with ETV for at least 4 year.A clinical and virological evaluation was performed at baseline and again at 12,24,36 and 48 months during ETV treatment.Fibrosis-4 (FIB-4) index was used to assess dynamic changes of liver fibrosis in HBeAg negative CHB patients after 1,2,3 and 4 years of ETV treatment.Results Liver biopsy was performed for all enrolled patients at baseline.According to Metavir fibrosis stages,numbers of patients with FI,F2,F3 and F4 were 95,108,50 and 15,respectively.The FIB-4 index enabled the effective identification of patients with severe fibrosis (Metavir F3-F4) with an area under the ROC curve of 0.775 (95％CI 0.716-0.834).The FIB-4 values significantly decreased in F2 and F3 patients after 1 and 2 years ETV therapy (P＜0.01),respectively.But for F4 patients,FIB-4 values decreased significantly at year 4 (P＜0.05).Conclusions FIB-4 values decreased significantly during 4-year ETV treatment in HBeAg-negative CHB patients indicating that these noninvasive fibrosis tests might be useful for monitoring improvement of liver fibrosis and assessing treatment efficacy during long-term ETV treatment.
