The Use of Serum Scoring Systems in Predicting Liver Fibrosis Caused by Chronic Hepatitis B: A Retrospective Case-Control Study

Background and Objectives: Early diagnosis and monitoring of liver fibrosis in chronic hepatitis B are crucial for effective disease management and prognosis. Traditionally, percutaneous liver biopsy has been regarded as the gold standard for assessing the degree of fibrosis histopathologically. However, this method has several drawbacks. Consequently, non-invasive serum scoring systems are becoming increasingly preferred. These serum scoring systems have emerged as valuable non-invasive tools for predicting liver fibrosis in patients with chronic hepatitis B. Multiple serum-based scoring systems have been developed and validated for this purpose. The aim of this study is to determine the role of serum scoring systems in chronic hepatitis B, evaluate their performance, and analyze their correlation with liver biopsy results. Materials and Methods: Patients diagnosed with Chronic Hepatitis B who underwent liver biopsy and were found to have liver fibrosis associated with chronic hepatitis B between August 2018 and July 2024 were included in this retrospective comparative case-control study and liver function tests, INR, alpha-fetoprotein levels, hemogram parameters, kidney function tests, and cholesterol levels at the time of biopsy were recorded. Results: The present study included a total of 249 patients, comprising 138 men (55.5%; mean age 42.1 years) and 111 women (44.5%; mean age 45.8 ± 13.5 years). The results of sixteen commonly used scoring systems in the current literature were evaluated for predicting fibrosis. According to ROC analysis, the most notable score identified was the KING score (0.775). The subsequent scores, in order, were AGAP (0.768), GUCI (0.748), FIB-4 (0.735), APRI (0.729), and S-INDEX (0.701). Conclusions: Non-invasive methods offer potential advantages over liver biopsy. While these scoring systems demonstrate good accuracy in identifying advanced fibrosis and cirrhosis, their performance in detecting mild to moderate fibrosis is generally less reliable. They can function as preliminary screening tests to identify patients who may require further evaluation or to prioritize individuals for more advanced imaging studies or liver biopsy.