Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
Division of Hepatobiliary, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2022 Jul;38(7):686-693. doi: 10.1002/kjm2.12543. Epub 2022 Apr 11.
Chronic hepatitis B (CHB) patients with low disease activity are at risk of liver fibrosis. The age-adjusted fibrosis-4 index (FIB4-AA), developed in our previous publication, and was implemented to evaluate the tendency of liver fibrosis in these patients. We aimed to investigate the rate of liver fibrosis in CHB patients with low disease activity. Resuming our previous study, the FIB-4 changes of 244 antiviral treatment-naïve CHB patients, with a total of 1243.48 person-years, were reviewed. Among the cohort, patients were categorized as FIB4-AA positive or negative according to the results of their last FIB4-AA minus their initial FIB-4 during at least 18 months of observation time. The compound annual growth rate (CAGR) of FIB-4 was calculated for the FIB4-AA positive and negative groups. The assumed healthy controls had an FIB-4 CAGR calculated to be 2.34% for both men and women, while the FIB-4 CAGR of the whole study cohort was 2.84% ± 6.01%. FIB4-AA positive effectively identifies CHB patients with higher mean FIB-4 CAGR (7.11% ± 3.88% vs. -2.36% ± 3.52%, p < 0.0001). Overweight CHB patients had 10 times smaller mean FIB-4 CAGR than lean ones (0.38% ± 10.35% vs. 3.83% ± 8.88%, p = 0.009). An increase in FIB4-AA over at least 18 months in CHB patients with relatively low disease activity meant they were at greater risk of liver fibrosis, and these patients had a mean FIB-4 CAGR of 7.11%. The FIB-4 CAGR was compatible with the findings of previous studies on the collagen proportionate area in viral hepatitis patients.
慢性乙型肝炎（CHB）患者疾病活动度低时存在发生肝纤维化的风险。我们之前的研究开发了年龄调整后的纤维化-4 指数（FIB4-AA），用于评估这些患者的肝纤维化倾向。我们旨在调查低疾病活动度 CHB 患者的肝纤维化发生率。在之前的研究中，我们回顾了 244 名未接受抗病毒治疗的 CHB 患者的 FIB-4 变化，共 1243.48 人年。在该队列中，根据至少 18 个月观察时间内最后一次 FIB4-AA 减去初始 FIB-4 的结果，将患者分为 FIB4-AA 阳性或阴性。计算 FIB4-AA 阳性和阴性组的 FIB-4 复合年增长率（CAGR）。假设健康对照组男性和女性的 FIB-4 CAGR 分别为 2.34%，而整个研究队列的 FIB-4 CAGR 为 2.84%±6.01%。FIB4-AA 阳性有效识别出 CHB 患者的平均 FIB-4 CAGR 较高（7.11%±3.88%比-2.36%±3.52%，p<0.0001）。超重 CHB 患者的平均 FIB-4 CAGR 比瘦者小 10 倍（0.38%±10.35%比 3.83%±8.88%，p=0.009）。在疾病活动度相对较低的 CHB 患者中，FIB4-AA 至少增加 18 个月意味着他们发生肝纤维化的风险更高，这些患者的平均 FIB-4 CAGR 为 7.11%。FIB-4 CAGR 与之前关于病毒性肝炎患者胶原比例面积的研究结果一致。
