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    Plos One A New Model Using Routinely Available Clinical

  • Citation: Seto W-K, Lee C-F, Lai C-L, Ip PPC, Fong DY-T, et al. (2011) A New Model Using Routinely Available Clinical Parameters to Predict Significant Liver Fibrosis in Chronic Hepatitis B. PLoS ONE 6(8): e23077. doi:10.1371/journal.pone.0023077

  • The primary endpoint of the present study was to determine whether there were associations between significant fibrosis which were present in 77 patients (32.4%) in the entire cohort, and the 12 routinely-available clinical parameters mentioned above. Data was randomly divided into a training cohort and a validation cohort. Concerning the optimal sample size of this study, with 32.4% of our patient cohort having significant fibrosis and allowing a 10% error for a 95% confidence interval, 84 patients were needed in each cohort for the study to be adequately powered. A training cohort consisting of 108 patients (45.6%) was used to develop the model. The remaining 129 patients (54.4%) formed the validation cohort. All statistical analyses were performed using SPSS version 16.0 (SPSS Inc., Chicago, IL), SAS system version 9.1, R version 2.81 and STATA/SE 9.2.

  • This new predictive model was compared to three pre-existing non-invasive indexes using routinely-available clinical parameters: the APRI, the FIB-4 index and the APGA index. The APRI was calculated using [AST (U/L)/(ULN of AST)/platelet count (×10

  • . Two other such models based on chronic hepatitis C patients, Fibrotest and Actitest, achieved satisfactory results in CHB patients, but were limited by the requirement of using special and non-routinely available biomarkers. In addition, the majority of the study population was HBeAg-negative

  • In conclusion, the PAPAS index, a newly-designed predictive model using routinely-available clinical parameters, can accurately predict significant liver fibrosis in CHB patients, and potentially reduce the need for liver biopsies. Further studies would be needed to validate this model and compare it with other non-invasive models of fibrosis in CHB.



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