Abstracts Poster Abstracts - Dr Falk

69Serum apolipoprotein A-I level predicts advanced liver fibrosis inchildren with chronic hepatitis BDariusz M. Lebensztejn 1 , E. Skiba 1 , J. Tobolczyk 2 , M. Sobaniec-Lotowska 3 ,M. Kaczmarski 11 IIIrd Department of Pediatrics, 2 Department of Children Allergology, 3 Department ofClinical Pathomorphology, Medical University of Bialystok, PolandIntroduction: Liver biopsy is thought mandatory for staging fibrosis in patients withchronic HBV infection, however there are no serum parameters that reliably predict thestage of liver fibrosis in children.The aim of the study was evaluation of diagnostic accuracy of potent serum biochemicalfibrosis markers: apolipoprotein A-I (ApoA-I), haptoglobin (HPT) and alpha-2-macroglobulin(A2M) in children with chronic hepatitis B evaluated by ROC analysis.Methods: We determined serum level of ApoA-I, HPT and A2M with an automaticnephelometer (BNII, Dade Behring) in 63 children (age range 4-17, mean 10 years) withbiopsy-verified chronic HBeAg-positive hepatitis B. Fibrosis stage and inflammationgrade were assessed in a blinded fashion according to Batts and Ludwig. We definedadvanced fibrosis as a score > 2. ROC analysis was used to calculate the power of theassays to detect advanced fibrosis (AccuROC, Canada).Results: Serum concentration of the examined markers were not significantly differentin patients with chronic hepatitis B compared to controls (n = 16). However, ApoA-I levelof 1.19 ng/l had a sensitivity of 85.7% and a specificity of 60.7%; AUC (95% CI) =0.7117 (0.5049-0.9186), p = 0.035 to predict advanced fibrosis. Correct classificationproportion of staging fibrosis was 63.5%. All other markers and their combination did notallow a useful prediction. None of these markers was a good predictor of histologicinflammation.Conclusion: ApoA-I may be a suitable serum marker to predict advanced liver fibrosisin children with chronic hepatitis B. Application of this marker may decrease the needfor liver biopsy in children with chronic HBV infection.