Prediction of liver fibrosis in patients with chronic hepatitis B by serum markers

Background/Aims: Liver biopsy has been considered as the gold standard for assessing fibrosis in patients with chronic hepatitis. The objective of this study was to explore the feasibility of using serum tests to predict the presence of fibrosis in patients with chronic hepatitis B. Methodology: Fibrosis scores for 153 patients were established by examining liver biopsy specimens. Serum was obtained from each patient around the time of the biopsy and analyzed by standard laboratory techniques. Student's t test, univariate analysis, and multivariate logistic regression were employed to test the presence of statistical significance. Results: Only platelet count was an independent factor that could predict the presence of significant fibrosis. Platelet count was lower (p=0.04) in the group with moderate/severe fibrosis. When platelet count was above 150x10(9)/L, the negative prediction value and specificity for the presence of significant fibrosis was 0.78 and 0.87 (AUC under ROC curve was 0.68). In this study, AST/ALT ratio was not associated with either activity or fibrosis. Conclusions: This study suggests that platelet count is an independent noninvasive marker for prediction of the presence of significant liver fibrosis in patients with chronic hepatitis B.