RESUMO
Objective@#To investigate the impact of hepatoprotective drugs on the performance of APRI for diagnosing liver fibrosis in chronic hepatitis B (CHB).@*Methods@#Patients with CHB who underwent a percutaneous liver biopsy were recruited and divided into hepatoprotective drugs using group and hepatoprotective drugs free group. Grouping was carried out according to the types of commonly used hepatoprotective drugs, and controls were matched for each groups by stage of liver fibrosis and age from hepatoprotective drugs free group. The performance of APRI for diagnosing significant fibrosis and cirrhosis was evaluated and compared between each experimental groups and control groups using receiver operating characteristic (ROC) curves.@*Results@#A total of 1447 patients were enrolled, including 60 using glycyrrhizin, 54 using silymarin, 63 using traditional Chinese medicine (TCM) containing schisandra, and 113 using more than one hepatoprotective drug. In patients using glycyrrhizin, the sensitivity of APRI to predict significant fibrosis was higher than its control group. In patients using more than one hepatoprotective drug, the sensitivity of APRI to exclude significant fibrosis was higher than its control group; the area under ROC curve of APRI to diagnose significant fibrosis, the specificity of APRI to exclude and predict significant fibrosis were all lower than its control group. In patients using glycyrrhizin and patients using more than one hepatoprotective drug, the specificity of APRI to exclude cirrhosis were both lower than their control groups. In patients using silymarin and patients using TCM, the performance of APRI to diagnose significant fibrosis and cirrhosis was comparable with their control groups.@*Conclusions@#Glycyrrhizin and combination of hepatoprotective drugs would have significant impact on the performance of APRI for diagnosing liver fibrosis in CHB, silymarin and TCM containing schisandra would have less impact.