Tseng TC, et al. - Experts explored the role of fibrosis-4 index (FIB-4) in the stratification of the risks of adverse liver events among treatment-naive, noncirrhotic the patients with chronic hepatitis B virus (HBV) infection. Findings illustrated a correlation between a higher FIB-4 index with increased risks of adverse liver events in noncirrhotic patients with chronic HBV infection. The inference drawn was that the FIB-4 index <1.29 was beneficial for the speculation of the lowest risks of disease progression.

Methods

• The recruited candidates included 2,075 treatment-naive, noncirrhotic the patients with chronic HBV infection.
• Maximum candidates (82.1%) were HBeAg-negative patients.
• In order to stratify the risks of cirrhosis, cirrhosis-related complications and liver-related mortality, an analysis was performed of their baseline FIB-4 levels.

Results

• A higher baseline FIB-4 index correlated with increased incidence rates of cirrhosis along with the common host and viral factors during a mean follow-up period of 15.47 years.
• Subjects with FIB-4 >1.29 vs those with FIB-4 <1.29, exhibited a connection with increased risks of cirrhosis, cirrhosis-related complications and liver-related mortality with the hazard ratio (95% confidence interval) of 6.19 (4.76-8.05), 6.88, (3.68-12.86) and 7.79, (4.54-13.37) respectively.
• As per the findings, FIB-4 remained stable and its kinetics demonstrated a consistent link with the development of adverse liver events within the first 3 years of follow-up.
• The FIB-4 index of 1.29 enabled the stratification of all the risks of adverse liver events even in HBeAg-negative patients with a low risk of disease progression (HBV DNA <2000 IU/mL, HBsAg <1000 IU/mL and ALT <40 U/L).
• The development of cirrhosis was noted in only 1 patient with FIB-4 index <1.29 but not other events within 15 years of follow-up.