Abstract: Objective The aim of this study was to investigate shear wave elastography(SWE) combined with aspartate aminotransferase (AST)/platelet (PLT) ratio index (APRI) and fibrosis factor 4 index (FIB-4) in predicting liver fibrosis (LF) in patients with serum HBeAg positive chronic hepatitis B (CHB). Methods 98 patients with serum HBeAg positive CHB were encountered inour hospital between September 2019 and September 2023, all underwent blood, serum, SWE and liver biopsies, and APRI and FIB-4 were calculated. Receiver operating characteristic curve (ROC) was applied to assess diagnostic efficacy. Results Of the 98 patients with serum HBeAgCHB, liver histo-pathological examination showed≤S1LF in 20 cases, S2 in 38 cases, S3 in 26 cases and S4 in 14 cases; serum AST and ALT levels in patients with ≤S1 were (39.8±6.0)U/L and (42.8±8.2)U/L, while they were much elevated in those with S2, S3 and S4(P＜0.05);APRI, FIB-4and Yang’s model in patients with S3 were (0.6±0.3),(1.7±0.5)and (10.1±0.7)kPa, in with S2 were (0.4±0.2),(1.2±0.4)and (7.1±0.5)kPa, all significantly greater than [(0.3±0.2),(0.8±0.3)and (6.3±0.7)kPa, respectively, P＜0.05]in patients with ≤S1; ROCanalysis demonstrated that the AUC was 0.84, with sensitivity (Se)and specificity(Sp)of 91% (P＜0.05)and 67%, in predicting significant LF, and theAUC was 0.92, with Se and Sp of 93%(P＜0.05)and 74%, in predicting advanced LF when combination of Yang’s model, APRI and FIB-4was used. Conclusion SWE and APRI plus FIB-4 would help clinicians preliminarily screen LF in patients with CHB.

Key words: Hepatitis B, Liver fibrosis, Shear wave elastography, Aspartate aminotransferase /platelet ratio index, Fibrosis factor 4 index, Diagnosis