OBJECTIVETo establish non-invasive predictors of antiviral therapy for chronic HBV carriers.

METHODSLiver biopsies were performed in 139 chronic HBV carriers. Seventeen of them were histopathologically graded as G > or =2 or S > or =3, being considered in need of antiviral therapy. The other 122 subjects with grades G < 2 and S < 3 were not applicable for antiviral therapy. Independent predictors were analyzed using logistic regression (Backward). The covariates included age, gender, duration of HBV infection, family history of hepatitis B, HBeAg positivity, quantitive HBeAg, level of LN, PCIII, HA, CIV and gamma-globin, low white blood cell count, spleen measurement and HBV load. ROC curve was used to define the diagnostic critical value.

RESULTSLogistic regression analysis showed that PCIII, but not other factors, was related to antiviral therapy in these HBV carriers (OR = 1.122). When the diagnostic critical value was 85.02 ng/ml, 100.79 ng/ml and 105.50 ng/ml, its sensitivity was 80.0%, 67.3% and 54.8%, respectively; its specificity was 52.0%, 70.6% and 84.2%, respectively. The area under ROC curve was 70.8%.

CONCLUSIONPCIII might be a reference index for predicting antiviral therapy in chronic HBV carriers, but liver biopsy is still a non-substutiable reference index.