Utility of the fibrosis-3 index for predicting liver fibrosis 5 years after achieving sustained virological response in patients with chronic hepatitis C - 06/06/25
, Hidenori Toyoda b , Takashi Kumada b, c , Satoshi Yasuda b , Yoshihiko Tachi d , Takanori Hirai e , Shohei Shiota a , Akiko Wakuta a , Kazuhiro Nouso a Highlights |
• | FIB-3 index offers superior diagnostic accuracy for liver fibrosis in post-SVR HCV patients. |
• | Age-independent FIB-3 significantly outperforms FIB-4 in patients aged ≥65 years. |
• | FIB-3 shows markedly improved specificity while maintaining sensitivity after SVR. |
• | FIB-3 reduces false positives in elderly HCV patients who achieved SVR. |
• | FIB-3 is an effective tool for long-term monitoring of liver fibrosis post-HCV eradication. |
Abstract |
Aim |
Non-invasive tests for liver fibrosis frequently use serum aminotransferases; however, their accuracy may be influenced by hepatitis virus eradication. This study evaluated the effectiveness of the age-independent FIB-3 index in patients with chronic hepatitis C who achieved sustained virological response (SVR).
Methods |
A total of 115 patients who achieved SVR following interferon therapy were analyzed. Liver fibrosis was assessed by biopsy before treatment and 5 years after achieving SVR. The diagnostic accuracies of the FIB-3 and FIB-4 indices were compared using Receiver Operating Characteristic (ROC) curve analysis and representative cutoff values (FIB-3:3.5, FIB-4:2.67), with a specific focus on age-stratified performance.
Results |
Age-stratified analysis revealed distinct patterns in fibrosis index performance before and after SVR. Among patients aged ≥ 65 years, both indices demonstrated poor accuracy pre-SVR (FIB-3:0.35, FIB-4:0.29) but markedly improved post-SVR, with FIB-3 demonstrating significantly superior performance (accuracy: 0.82 vs 0.64). This improvement was primarily due to better specificity (FIB-3:0.85 vs FIB-4,0.60) while maintaining high sensitivity (0.62 vs 0.87). In patients aged < 65 years, both indices exhibited modest improvement post-SVR, with no significant differences observed.
Conclusions |
At established cutoff values, the FIB-3 index demonstrated significantly higher diagnostic performance than the FIB-4 index, particularly in patients aged ≥ 65 years who achieved SVR. These findings suggest that the FIB-3 index is a reliable tool for long-term monitoring of liver fibrosis after hepatitis C eradication.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Keywords : FIB-3 index, FIB-4 index, Liver fibrosis, Hepatitis C, Age, SVR
Abbreviations : HCV, SVR, NITs, FIB-4, FIB-3, IFN, PEG-IFN, HCC, AUROC, AIC, ALT, AST, PLT, ROC
Plan
| The data, analytical methods, and research materials used in this study were not available to other researchers. |
Vol 49 - N° 7
Article 102625- juillet 2025 Retour au numéro
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