King's Score may be More Effective in the Determination of Severe Fibrosis in Chronic Hepatitis B Infections

Abstract

Objective: The objective of this study was to compare the performances of several noninvasive indirect biochemical markers used to detect advanced fibrosis in patients with chronic hepatitis B (CHB). Materials and Methods: This study was retrospectively conducted in two centers, and included treatment-naive CHB patients undergoing liver needle biopsies. The following noninvasive biochemical markers were used: the aspartate aminotransferase to platelets ratio index (APRI), Fibrosis 4 (FIB-4) index, Goteborg University Cirrhosis index (GUCI), King's score, FibroQ score, aspartate aminotransferase to alanine aminotransferase ratio (AAR), Cirrhosis Discriminant Score (CDS) Bonacini, and age-platelet (AP) index. Results: This study included a total of 255 patients (79.6% males), with a median age of 27 years (19-69). The AAR did not show a significant difference in predicting severe fibrosis according to the area under the curve (AUC) and p values (AUC=0.493, p=0.887) of the non-invasive methods. Overall, the APRI, FIB-4, GUCI, and King' score were more effective (all p values <0.001; AUC values: 0.787, 0.768, 0.775, and 0.807; respectively). Conclusion: In our study group, the highest AUC and positive likelihood ratio (LR+) values were found using King's score. Therefore, King's score seems to be more selective in the classification of patients with severe fibrosis among CHB patients, because of its higher correct predictive value.