Abstract: Objective The aim of this study was to investigate diagnostic efficacy of transient elastography (TE) with combination of fibrosis-4 index (FIB-4) and aspartate aminotransferase to platelet ratio index (APRI) in assessing significant liver fibrosis (SLF) in patients with chronic hepatitis B(CHB). Methods A total of 102 consecutive patients with CHB were enrolled in our hospital between January 2022 and October 2024, and all received liver biopsies, TE for liver stiffness measurement (LSM), routine blood tests to calculate FIB-4 and APRI. Multivariate Logistic regression analysis was applied to reveal influencing factors, and receiver operating characteristic curve (ROC) was used to evaluate diagnostic performance. Results Of the 102 patients with CHB, liver histo-pathological examination found liver fibrosis stage 0 (S0) in 11 cases, S1 in 25 cases and S2 or above (SLF) in 66 cases; LSM, FIB-4 and APRI in patients with SLF were (11.6±2.1)kPa, (1.6±0.4) and (0.6±0.1), all much higher than [(5.6±1.4)kPa, (1.3±0.5) and (0.4±0.1), respectively, P<0.05] in those without LF; multivariate Logistic regression analysis showed that LSM (OR:2.857,95%CI:1.048-7.783), FIB-4(OR:2.886, 95%CI:1.267-6.575) and APRI(OR:2.264, 95%CI:1.371-3.739) were all the independent risk factors for SLF in patients with CHB(P<0.05); ROC analysis demonstrated that the AUC was 0.930(95%CI:0.861-0.971), when LSM in combination with FIB-4 and APRI in predicting SLF, much superior to any parameter did alone (P<0.05). Conclusion TE in combination with FIB-4 and APRI could improve the diagnostic efficacy for SLF in patients with CHB.

Key words: Hepatitis B, Liver fibrosis, Transient elastography, Fibrosis-4 index, Aspartate aminotransferase to platelet ratio index, Diagnosis