Guo ZZ, Wang Y, Liu XX, Yang SS, Yu F. Liver stiffness-based composite indices for compensated and decompensated cirrhosis in chronic hepatitis B. World J Hepatol 2026; 18(6): 121259 [DOI: 10.4254/wjh.121259]
Corresponding Author of This Article
Zhi-Zun Guo, Department of Infectious Diseases, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, No. 99 Longcheng Street, Taiyuan 030032, Shanxi Province, China. guozhizun@sxbqeh.com.cn
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Gastroenterology & Hepatology
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research-article
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Guo ZZ, Wang Y, Liu XX, Yang SS, Yu F. Liver stiffness-based composite indices for compensated and decompensated cirrhosis in chronic hepatitis B. World J Hepatol 2026; 18(6): 121259 [DOI: 10.4254/wjh.121259]
World J Hepatol. Jun 27, 2026; 18(6): 121259 Published online Jun 27, 2026. doi: 10.4254/wjh.121259
Liver stiffness-based composite indices for compensated and decompensated cirrhosis in chronic hepatitis B
Zhi-Zun Guo, Yan Wang, Xiao-Xuan Liu, Shan-Shan Yang, Fan Yu
Zhi-Zun Guo, Yan Wang, Xiao-Xuan Liu, Shan-Shan Yang, Fan Yu, Department of Infectious Diseases, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan 030032, Shanxi Province, China
Author contributions: Guo ZZ participated in the conception and design of the study, wrote the manuscript, and was involved in the acquisition, analysis, and interpretation of data; Wang Y and Liu XX performed the statistical analysis; Yang SS and Yu F collected the data. All authors critically reviewed and provided final approval of the manuscript; and all authors were responsible for the decision to submit the manuscript for publication.
Institutional review board statement: The study was reviewed and approved by the Shanxi Bethune Hospital Institutional Review Board, Approval No. YXLL-2025-071.
Informed consent statement: The need for patient consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: There was no conflict of interest to be reported.
Data sharing statement: The anonymized dataset can be made available from the corresponding author at guozhizun@sxbqeh.com.cn.
Corresponding author: Zhi-Zun Guo, Department of Infectious Diseases, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, No. 99 Longcheng Street, Taiyuan 030032, Shanxi Province, China. guozhizun@sxbqeh.com.cn
Received: March 21, 2026 Revised: April 9, 2026 Accepted: April 24, 2026 Published online: June 27, 2026 Processing time: 94 Days and 12.3 Hours
Abstract
BACKGROUND
Chronic hepatitis B virus (HBV) infection remains a major global public health challenge. Accurate assessment of disease progression is essential for managing patients with chronic HBV infection. Despite the use of liver biopsy, imaging tests, and non-invasive models, their inherent limitations restrict widespread application. Thus, there is a pressing need to establish an effective non-invasive diagnostic model for assessing disease progression in patients with chronic HBV infection, particularly one that integrates imaging tests with demographic and hematologic parameters.
AIM
To develop novel non-invasive composite indices for evaluating the condition of chronic HBV-infected patients.
METHODS
This retrospective study enrolled 132 chronic HBV-infected patients who were admitted to the Department of Infectious Diseases, Shanxi Bethune Hospital, Taiyuan, China, between August 1, 2020 and June 30, 2024. Demographic variables, hematological parameters, and liver stiffness measurement (LSM) were recorded. Multivariable logistic regression was constructed to identify independent predictors of chronic hepatitis B (CHB), compensated and decompensated hepatitis B cirrhosis. The logistic regression diagnostic model was fitted with the selected predictors. Receiver operating characteristic (ROC) curves were generated to assess diagnostic performance of the model.
RESULTS
We developed three non-invasive models-A-index for CHB, MAPTAL for compensated hepatitis B cirrhosis, and APTAL for decompensated hepatitis B cirrhosis-which achieved area under the ROC curve of 0.948, 0.918, and 0.968, respectively.
CONCLUSION
The MAPTAL and APTAL indices, integrating LSM with routine demographic and hematologic variables, reliably predict progression to compensated and decompensated HBV-related cirrhosis, respectively.
Core Tip: This is a retrospective study aimed at developing novel non-invasive composite indices to evaluate the condition of chronic hepatitis B virus (HBV)-infected patients. Three models, named the A-index, MAPTAL index, and APTAL index, were constructed to predict disease progression stages. Importantly, the MAPTAL and APTAL indices, which incorporate readily available demographic, hematologic, and liver stiffness measurement parameters, can reliably predict compensated and decompensated HBV-related cirrhosis, respectively.
