Liver Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China.
Department of Pharmacy, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China.
World J Gastroenterol. 2020 Jul 21;26(27):3952-3962. doi: 10.3748/wjg.v26.i27.3952.
The presence of significant liver fibrosis in hepatitis B virus (HBV)-infected individuals with persistently normal serum alanine aminotransferase (PNALT) levels is a strong indicator for initiating antiviral therapy. Serum ceruloplasmin (CP) is negatively correlated with liver fibrosis in HBV-infected individuals.
To examine the potential value of serum CP and develop a noninvasive index including CP to assess significant fibrosis among HBV-infected individuals with PNALT.
Two hundred and seventy-five HBV-infected individuals with PNALT were retrospectively evaluated. The association between CP and fibrotic stages was statistically analyzed. A predictive index including CP [Ceruloplasmin hepatitis B virus (CPHBV)] was constructed to predict significant fibrosis and compared to previously reported models.
Serum CP had an inverse correlation with liver fibrosis ( = -0.600). Using CP, the areas under the curves (AUCs) to predict significant fibrosis, advanced fibrosis, and cirrhosis were 0.774, 0.812, and 0.853, respectively. The CPHBV model was developed using CP, platelets (PLT), and HBsAg levels to predict significant fibrosis. The AUCs of this model to predict significant fibrosis, advanced fibrosis, and cirrhosis were 0.842, 0.920, and 0.904, respectively. CPHBV was superior to previous models like the aspartate aminotransferase (AST)-to-PLT ratio index, Fibrosis-4 score, gamma-glutamyl transpeptidase-to-PLT ratio, Forn's score, and S-index in predicting significant fibrosis in HBV-infected individuals with PNALT.
CPHBV could accurately predict liver fibrosis in HBV-infected individuals with PNALT. Therefore, CPHBV can be a valuable tool for antiviral treatment decisions.
乙型肝炎病毒（HBV）感染者持续正常血清丙氨酸氨基转移酶（PNALT）水平存在显著肝纤维化是启动抗病毒治疗的强烈指征。血清铜蓝蛋白（CP）与 HBV 感染者的肝纤维化呈负相关。
检验血清 CP 的潜在价值，并建立一种包含 CP 的非侵入性指数，以评估 PNALT 的 HBV 感染者的显著纤维化。
回顾性评估了 275 名 HBV 感染者 PNALT。统计分析 CP 与纤维化分期之间的关系。构建了一个包含 CP 的预测指数[CP 乙型肝炎病毒（CPHBV)]，以预测显著纤维化，并与之前报道的模型进行比较。
血清 CP 与肝纤维化呈负相关（r = -0.600）。使用 CP，预测显著纤维化、进展性纤维化和肝硬化的曲线下面积（AUCs）分别为 0.774、0.812 和 0.853。CPHBV 模型是使用 CP、血小板（PLT）和 HBsAg 水平构建的，用于预测显著纤维化。该模型预测显著纤维化、进展性纤维化和肝硬化的 AUC 分别为 0.842、0.920 和 0.904。CPHBV 在预测 PNALT 的 HBV 感染者的显著纤维化方面优于以前的模型，如天冬氨酸氨基转移酶（AST）-血小板比值指数、纤维化-4 评分、γ-谷氨酰转肽酶-血小板比值、Forn's 评分和 S 指数。
CPHBV 可准确预测 PNALT 的 HBV 感染者的肝纤维化。因此，CPHBV 可以成为抗病毒治疗决策的有用工具。
