{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T22:32:22Z","timestamp":1788906742307,"version":"build-2803163510"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T00:00:00Z","timestamp":1652832000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 index (FIB-4) are the two most widely studied noninvasive markers of liver fibrosis. We aimed to assess the diagnostic accuracy of APRI and FIB-4 for liver fibrosis in patients with autoimmune hepatitis (AIH) using liver biopsy as the reference standard.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PubMed, EMBASE, Cochrane Library and Web of Science databases were searched for studies (published as of May 1st, 2021) that assessed the diagnostic performance of APRI and FIB-4 for liver fibrosis in AIH. The summary area under receiver operating characteristics curve (AUROC), sensitivity, specificity, diagnostic odds ratios were used to assess the diagnostic accuracy of APRI and FIB-4 for detecting liver fibrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fourteen studies (including 1015 patients) were selected with 13 studies each evaluating the use of APRI and FIB-4 for detecting different stages of fibrosis in AIH. For prediction of significant fibrosis, advanced fibrosis, and cirrhosis, the summary AUROC value was 0.66 [95% confidence interval (CI): 0.61\u20130.70], 0.71 (95% CI: 0.67\u20130.75), and 0.75 (95% CI: 0.71\u20130.79) for APRI, and the summary AUROC value was 0.75 (95% CI: 0.71\u20130.79), 0.73 (95% CI: 0.69\u20130.77) and 0.79 (95% CI: 0.75\u20130.82) for FIB-4, respectively. The summary sensitivity and specificity for diagnosis of significant fibrosis, advanced fibrosis, and cirrhosis were 90% and 36%, 78% and 55%, and 77% and 61% for APRI, and 70% and 70%, 65% and 70%, and 78% and 65% for FIB-4, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>APRI and FIB-4 showed suboptimal diagnostic performance for identifying liver fibrosis in AIH with mediocre sensitivity and specificity.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2022.892454","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T04:57:45Z","timestamp":1652849865000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":24,"title":["Aspartate Aminotransferase to Platelet Ratio Index and Fibrosis-4 Index for Detecting Liver Fibrosis in Patients With Autoimmune Hepatitis: A Meta-Analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Bingtian","family":"Dong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuping","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guorong","family":"Lyu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaocen","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"58","DOI":"10.3350\/cmh.2020.0189","article-title":"Recent Updates on the Management of Autoimmune Hepatitis","volume":"27","author":"Komori","year":"2021","journal-title":"Clin Mol Hepatol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1002\/hep.31065","article-title":"Diagnosis and Management of Autoimmune Hepatitis in Adults and Children: 2019 Practice Guidance and Guidelines From the American Association for the Study of Liver Diseases","volume":"72","author":"Mack","year":"2020","journal-title":"Hepatology"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.5009\/gnl19261","article-title":"Autoimmune Hepatitis: 2019 Update","volume":"14","author":"Tanaka","year":"2020","journal-title":"Gut Liver"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.14746","article-title":"Systematic Review and Meta-Analysis on the Incidence and Prevalence of Autoimmune Hepatitis in Asian, European, and American Population","volume":"34","author":"Lv","year":"2019","journal-title":"J Gastroenterol Hepatol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20235","article-title":"Progressive Fibrosis During Corticosteroid Therapy of Autoimmune Hepatitis","volume":"39","author":"Czaja","year":"2004","journal-title":"Hepatology"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2013.09.020","article-title":"Autoimmune Liver Disease, Autoimmunity and Liver Transplantation","volume":"60","author":"Carbone","year":"2014","journal-title":"J Hepatol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2994","DOI":"10.3748\/wjg.v27.i22.2994","article-title":"Hepatocellular Carcinoma in Viral and Autoimmune Liver Diseases: Role of CD4+ CD25+ Foxp3+ Regulatory T Cells in the Immune Microenvironment","volume":"27","author":"Granito","year":"2021","journal-title":"World J Gastroenterol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1016\/j.jhep.2015.06.030","article-title":"European Association for the Study of the Liver. 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