The Easy Liver Fibrosis Test (eLIFT) for predicting advanced liver fibrosis in patients with chronic hepatitis B

Discov Med. 2019 Sep;28(153):149-158.

Abstract

Objective: The easy liver fibrosis test (eLIFT) is a novel index to assess advanced liver fibrosis in chronic liver diseases. We aimed to investigate the diagnostic accuracy of eLIFT for advanced liver fibrosis in patients with chronic hepatitis B (CHB).

Methods: A total of 294 CHB patients with liver biopsy were enrolled. The diagnostic accuracy of eLIFT for advanced liver fibrosis was evaluated and compared to aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis-4 score (FIB-4), gamma-glutamyl transpeptidase-to-platelet ratio (GPR), and red cell distribution width-to-platelet ratio (RPR) by ROC curves.

Results: The area under ROC curves (AUROCs) of eLIFT in predicting advanced fibrosis were 0.687 (95%CI 0.621 to 0.753), 0.714 (95%CI 0.631 to 0.798), and 0.633 (95%CI 0.522 to 0.744) in the entire cohort of CHB patients, HBeAg positive CHB patients, and HBeAg negative CHB patients, respectively. The optimal cut-off values of eLIFT for predicting advanced fibrosis in these three groups were 9.5. The eLIFT, as an easy-to-use scoring system, was comparable with APRI, FIB-4, GPR, and RPR in identifying advanced fibrosis in both HBeAg positive CHB and HBeAg negative CHB patients.

Conclusions: eLIFT as a novel index can predict advanced liver fibrosis with a moderate sensitivity and accuracy in CHB patients. eLIFT, though having similar diagnostic values of advanced liver fibrosis compared to more complex existing tools such as APRI, FIB-4, GPR, and RPR in CHB patients, has the advantage of clarity of generation and ease of application and has the potential of being widely used by hepatologists.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aspartate Aminotransferases / blood
  • Biomarkers / blood
  • Biopsy
  • Disease Progression
  • Female
  • Hepatitis B e Antigens / isolation & purification
  • Hepatitis B virus / immunology
  • Hepatitis B virus / isolation & purification
  • Hepatitis B, Chronic / blood
  • Hepatitis B, Chronic / pathology*
  • Humans
  • Liver / pathology*
  • Liver / virology
  • Liver Cirrhosis / blood
  • Liver Cirrhosis / diagnosis*
  • Liver Cirrhosis / pathology
  • Liver Function Tests
  • Male
  • Platelet Count
  • Predictive Value of Tests
  • ROC Curve
  • Retrospective Studies
  • Severity of Illness Index*
  • gamma-Glutamyltransferase / blood

Substances

  • Biomarkers
  • Hepatitis B e Antigens
  • gamma-Glutamyltransferase
  • Aspartate Aminotransferases