annual change in fib-4, but not in apri, was a strong predictor for liver disease progression in chinese patients with chronic hepatitis c

Background: previous studies showed a significant prognostic value of 3-year and 5-year evolution of noninvasive fibrosis tests in european chronic hepatitis c (chc) patients with or without hiv. it is uncertain whether this conclusion can be extrapolated to chinese patients and whether the assessment of noninvasive fibrosis tests in a shorter time interval still has a prognostic value. objectives: the study aimed to assess the prognostic value of changes of aspartate aminotransferase-to-platelet ratio (apri) and fibrosis-4 (fib-4) in consecutive years in chinese chc patients. methods: there were 173 chc patients enrolled in 2 centers in this retrospective study. apri and fib-4 were calculated every 122 months. the average difference between 2 adjacent calculations was defined as an annual change (ac). risk factors were evaluated by cox proportional regression models. results: cirrhosis, hepatic decompensation, hepatocellular carcinoma, and liver-related death developed in 29 patients during the median follow-up of 47.0 (29.5 - 72.0) months. baseline fib-4 and apri, child-pugh class c, non-sustained virologic response (svr) to interferon (ifn) or pegylated ifn plus ribavirin, and ac of fib-4 were significantly associated with liver disease progression. ac of fib-4 (p < 0.001) exhibited a more robust prognostic value than ac of apri (p = 0.228). excellent prognosis was observed in patients with ac of fib-4 ≤ 0.22 and baseline fib-4 ≤ 3.25, or ac of fib-4 ≤ 0.22 and svr. patients with baseline fib-4 > 3.25 and ac of fib-4 > 0.22, or non-svr and ac of fib-4 > 0.22 had the highest cumulative incidence of liver disease progression among the 4 groups identified according to baseline fib-4 and ac of fib-4, or svr and ac of fib-4. conclusions: an increased fib-4 over time is an independent risk factor of liver disease development in chinese chc patients. monitoring fib-4 annually may help physicians to predict prognosis in chc patients.