Kronik viral hepatit B'de fibrozisin noninvaziv biyokimyasal testlerle değerlendirilmesi

INTRODUCTION AND AIM: Chronic viral hepatitis B (HBV) is a common disease that causes cirrhosis and liver cancer. Early diagnosis and treatment of this disease is important for preventing possible complications. Liver biopsy is an invasive, complicating and expensive diagnostic method, which is the gold standard for detecting of fibrosis. Therefore, in recent years, the development of non-invasive and practical testing has gained importance to show liver fibrosis. The aim of our study is to investigate the role of these tests in predicting liver fibrosis and treatment decision. MATERIAL AND METHOD: A total of 1051 patients were retrospectively evaluated who diagnosed with chronic hepatitis B between 2010-2020 in the Gastroenterology and Hepatology clinic of Gaziantep University Faculty of Medicine. AAR, API, APRI, FIB-4, KING score, FIBROQ score were calculated at the time of onset diagnosis. In addition, GAZİANTEP score, a new formula that is thought to be more sensitive and specific, was determined. Non-invasive fibrosis scores were compared according to the biopsy results of the patients. RESULTS: İn our study, the area values under curve were 0.648 for API score, 0.711 for APRI score, 0.716 for FIB-4 score, 0.723 for KİNG score, 0.595 for FIBROQ score, 0.701 for GAZİANTEP score (p<0.05). No statistically significant p value was obtained for AAR score. KİNG, FİB-4, APRI and GAZİANTEP scores were the best indicators for the detection of advanced fibrosis. For KİNG, FİB-4, APRI and GAZİANTEP score, the cut-off value for the prediction of advanced fibrosis were ≥ 8.67, ≥ 0.94, ≥ 16.24 and ≥ 9.63 with a sensitivity of %50.52, %56.77, %59.64 and %52.34, specificity of %87.26, %74.96, %73.61 and %78.11 respectively (p<0.05). In our study, we compared the globulin and GGT parameters with fibrosis, which we used in the GAZIANTEP score formula. Globulin and GGT mean values were significantly higher in the fibrosis group (p <0.05). There was statistically significant correlation between fibrosis and globulin and GGT values (respectively, p<0,05; r=0,230; p<0,05; r=0,305). CONCLUSION: As a result of the study, the King score was found to be the most reliable method for non-invasive detection of hepatic fibrosis in patients with chronic HBV. FIB-4, ARPI and GAZIANTEP scores were also shown to be effective in determining liver fibrosis. It was shown that the AAR score was not sufficient for detecting hepatic fibrosis. GAZİANTEP score, a novel noninvasive test, is an useful and easy tool to evaluate liver fibrosis in patients with chronic HBV and has better accuracy than AAR, API and FIBROQ. Further prospective studies are warranted to validate its efficacy. Keywords: Chronic viral hepatitis B, Fibrosis, Non-invasive tests