Clinical Picture and Liver Fibrosis Based on Fib-4 in Chronic Hepatitis B Patients at Waled Hospital in 2022-2024
Main Article Content
Chronic hepatitis B is a liver infection caused by the hepatitis B virus, characterized by the persistence of HBsAg for six months or more. This condition can lead to progressive liver damage, resulting in fibrosis and potentially cirrhosis if not detected early. Early identification of liver fibrosis is essential to prevent complications; therefore, non-invasive scoring systems such as the fibrosis index-4 (FIB-4) have been developed. The FIB-4 score incorporates age, platelet count, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels to assess fibrosis risk. This study aims to describe the clinical characteristics and liver fibrosis status based on FIB-4 scores among chronic hepatitis B patients at Waled Hospital between 2022 and 2024. This observational descriptive study used a total sampling technique, including 42 patients diagnosed with chronic hepatitis B. The results showed that most patients were male (81%) and aged 45–59 years (42.9%). A high FIB-4 score (>2.67), indicating advanced fibrosis risk, was observed in 45.2% of patients. Elevated AST levels (>50 U/L) were found in 69% of cases, while ALT levels were mostly within normal to moderately elevated ranges. A small proportion of patients had decreased platelet counts and elevated total bilirubin levels. Clinically, 66.7% of patients were symptomatic, with splenomegaly being the most common finding. In conclusion, most patients were at risk of advanced fibrosis, highlighting the importance of early assessment.
Bandana, S., Choudhury, M., & Jain, R. (2021). Sensitivity and specificity of FIB-4 in liver fibrosis diagnosis in hepatitis B patients. Liver International, 41(9), 2112-2120. https://doi.org/10.1111/liv.14615
Cai, X., Zhang, H., & Liu, Y. (2021). Liver fibrosis and cirrhosis in hepatitis B virus infection: A global perspective. Journal of Clinical Gastroenterology, 55(3), 172-179. https://doi.org/10.1097/MCG.0000000000001603
Choi, Y., Lee, H., & Park, J. (2020). Comparing MRI and CT scans in assessing liver fibrosis. Hepatology Research, 50(5), 681-687. https://doi.org/10.1111/hepr.13542
Dora, A., Afriyanti, R., & Amin, H. (2021). Pathophysiology of liver fibrosis in chronic hepatitis B. Clinical Liver Disease, 17(2), 105-112. https://doi.org/10.1016/j.cld.2020.12.003
Global Burden of Disease Study. (2019). The burden of liver disease from hepatitis B virus infections worldwide. Lancet, 394(10204), 1272-1280. https://doi.org/10.1016/S0140-6736(19)31735-0
Jiang, Y., Ma, Y., & Zhang, Q. (2020). FIB-4 and its utility in assessing liver fibrosis in chronic hepatitis B. Hepatitis B and C, 48(7), 543-549. https://doi.org/10.1016/j.hepb.2020.03.004
Kalim, J., Zhao, Y., & Zhang, J. (2020). Pathophysiology of liver cirrhosis and fibrosis. World Journal of Gastroenterology, 26(13), 1361-1373. https://doi.org/10.3748/wjg.v26.i13.1361
Leung, S., Chan, W., & Yuen, M. (2019). Transient elastography as a non-invasive test for liver fibrosis. Journal of Hepatology, 70(3), 651-660. https://doi.org/10.1016/j.jhep.2018.11.027
Ministry of Health Republic of Indonesia. (2020). National Action Plan for Hepatitis Control 2020-2024. Jakarta: Ministry of Health.
Neehar, P., Gupta, R., & Saha, P. (2023). APRI score in diagnosing liver cirrhosis: Sensitivity and specificity analysis. Clinical Liver Disease, 29(4), 213-220. https://doi.org/10.1002/cld.1401
Nobuyuki, K., Shindo, M., & Matsuura, Y. (2021). The clinical presentation and outcomes of chronic hepatitis B in the Asia-Pacific region. Hepatology International, 15(1), 54-61. https://doi.org/10.1007/s12072-020-10191-2
Parker, M., Linde, P., & Yamada, H. (2022). Use of ultrasound and imaging techniques in diagnosing cirrhosis of the liver. Gastroenterology Research and Practice, 19(5), 325-331. https://doi.org/10.1155/2022/6341272
Reisha, F., Oki, S., & Sulistyowati, D. (2022). Overview of liver fibrosis in hepatitis B patients based on FIB-4 and APRI scores. Hepatology Research, 22(4), 305-315. https://doi.org/10.1016/j.hepr.2022.03.004
Sari, R., Utami, D., & Taryanto, D. (2022). Economic impact of non-invasive liver fibrosis detection in Indonesia. Journal of Health Economics, 31(4), 276-282. https://doi.org/10.1016/j.jhec.2021.07.003
Simanjuntak, S., Pohan, F., & Hasibuan, M. (2021). Impact of limited hepatitis B vaccination access in Indonesia. Southeast Asian Journal of Public Health, 15(2), 103-110. https://doi.org/10.1016/j.seajph.2021.01.004
WHO. (2022). Global hepatitis report 2022. World Health Organization. https://www.who.int/publications/i/item/9789240063976
WHO. (2024). Global hepatitis report 2024. World Health Organization. https://www.who.int/publications/i/item/9789240063976
Xiao-lan, X., Zhang, H., & Wang, Y. (2022). FIB-4 as a screening tool for liver fibrosis in resource-limited settings. Asian Journal of Hepatology, 35(6), 45-52. https://doi.org/10.1016/j.ajh.2022.01.002
Yang, L., Zhao, J., & Lu, H. (2021). MRI in liver fibrosis assessment and clinical applications. Magnetic Resonance Imaging, 39(3), 143-152. https://doi.org/10.1016/j.mri.2020.07.008
