{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T22:50:53Z","timestamp":1789599053333,"version":"build-2803163510"},"reference-count":49,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,2,22]],"date-time":"2017-02-22T00:00:00Z","timestamp":1487721600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007229","name":"Bijzonder Onderzoeksfonds","doi-asserted-by":"publisher","award":["201302010"],"award-info":[{"award-number":["201302010"]}],"id":[{"id":"10.13039\/501100007229","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003395","name":"Shanghai Municipal Education Commission","doi-asserted-by":"publisher","award":["15ZZ057"],"award-info":[{"award-number":["15ZZ057"]}],"id":[{"id":"10.13039\/501100003395","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Several noninvasive blood biomarkers have been established for the assessment of liver fibrosis in patients with chronic hepatitis B virus (<jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content>) infection, but their clinical performance remains inconclusive. Here, we compared the diagnostic performance of these biomarkers and developed a novel algorithm for assessing liver fibrosis. Six hundred and sixteen chronically <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content>\u2010infected and treatment\u2010na\u00efve patients who underwent liver biopsy were enrolled and randomly divided into training (N=410) and internal validation cohorts (N=206). One hundred and fifty\u2010nine patients from another centre were recruited as an external validation cohort. Receiver operating characteristic (<jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content>) curves were used to analyse the performance of the gamma\u2010glutamyltransferase\u2010to\u2010platelet ratio (<jats:styled-content style=\"fixed-case\">GPR<\/jats:styled-content>), red cell volume distribution width\u2010to\u2010platelet ratio (<jats:styled-content style=\"fixed-case\">RPR<\/jats:styled-content>), <jats:styled-content style=\"fixed-case\">FIB<\/jats:styled-content>\u20104 index, aspartate aminotransferase\u2010to\u2010platelet ratio index (<jats:styled-content style=\"fixed-case\">APRI<\/jats:styled-content>) and <jats:styled-content style=\"fixed-case\">HBV DNA<\/jats:styled-content> level against liver histology, and a novel algorithm was developed using the recursive partitioning and regression tree (<jats:styled-content style=\"fixed-case\">RPART<\/jats:styled-content>) method. In the training cohort, the area under the <jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content> curve of <jats:styled-content style=\"fixed-case\">FIB<\/jats:styled-content>\u20104 was significantly higher than that of <jats:styled-content style=\"fixed-case\">APRI<\/jats:styled-content> (<jats:italic>P<\/jats:italic>=.038) but was comparable to those of <jats:styled-content style=\"fixed-case\">GPR<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> RPR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">HBV DNA<\/jats:styled-content>; however, the performance of the biomarkers was similar among the validation cohort. The established <jats:styled-content style=\"fixed-case\">RPR<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">HBV DNA<\/jats:styled-content> algorithm performed better in the training cohort than any individual blood biomarker, and the corresponding sensitivity, specificity, positive predictive value and negative predictive value were 63%, 90%, 72% and 80%, respectively. In the internal and external validation cohorts, the performance of the algorithm in assessing liver fibrosis was also superior to that of other biomarkers. These results suggest that the established <jats:styled-content style=\"fixed-case\">RPR<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">HBV DNA<\/jats:styled-content> algorithm might improve the diagnostic accuracy of liver fibrosis in treatment\u2010na\u00efve patients with chronic <jats:styled-content style=\"fixed-case\">HBV<\/jats:styled-content> infection, although additional studies are warranted to confirm these findings.<\/jats:p>","DOI":"10.1111\/jvh.12682","type":"journal-article","created":{"date-parts":[[2017,1,28]],"date-time":"2017-01-28T01:23:22Z","timestamp":1485566602000},"page":"589-598","source":"Crossref","is-referenced-by-count":27,"title":["A novel noninvasive algorithm for the assessment of liver fibrosis in patients with chronic hepatitis B virus infection"],"prefix":"10.1111","volume":"24","author":[{"given":"M.\u2010Y.","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Ruijin Hospital School of Medicine Shanghai Jiao Tong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X.","family":"Zou","sequence":"additional","affiliation":[{"name":"Ministry of Education Key Laboratory of Systems Biomedicine Shanghai Center for Systems Biomedicine Shanghai Jiao Tong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Q.","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hepatitis Shanghai Public Health Clinical Center Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.\u2010M.","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Ruijin Hospital School of Medicine Shanghai Jiao Tong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z.\u2010T.","family":"Yang","sequence":"additional","affiliation":[{"name":"P\u00f4le Sino\u2010Fran\u00e7ais de Recherches en Science du Vivant et G\u00e9nomique Ruijin Hospital School of Medicine Shanghai Jiao Tong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Ruijin Hospital School of Medicine Shanghai Jiao Tong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5847-4888","authenticated-orcid":false,"given":"J.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Ruijin Hospital School of Medicine Shanghai Jiao Tong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Q.\u2010M.","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Ruijin Hospital School of Medicine Shanghai Jiao Tong University  Shanghai 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