Contradictory results of the accuracy of biochemical markers to predict the stage of fibrosis in black African patients with chronic hepatitis B (CHB) were previously published. We conducted a prospective cohort study to determine the diagnostic accuracy of aspartate aminotransferase to platelet ratio (APRI), aspartate aminotransferase to alanine aminotransferase ratio (AAR), platelet count, age-platelet (AP) index, and FIB-4 index for the prediction of significant fibrosis or cirrhosis in 117

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... lack African patients (median age: 38 years, males: 73%) with CHB not previously treated. Among them, 45 had significant fibrosis and 18 had cirrhosis using the METAVIR score system. Factors associated either with significant fibrosis or cirrhosis were determined in logistic multivariate analysis. Areas under receiver operating curve were assessed and compared for APRI, AAR, AP index, FIB-4 index and platelet count. Sensitivity, specificity, positive and negative predictive values were determined for each biochemical markers. Multivariate analysis showed that aspartate aminotransferase (p < 0.0001) and platelets (p = 0.03) were the independent factors associated with significant fibrosis and only platelets (p = 0.01) were associated with cirrhosis. APRI (cut-off > 1.1) and FIB-4 index (cut-off > 2.1) ruled out significant fibrosis with high specificity of 84.7% and 86.1% respectively and negative predictive values of 78.2% and 72.9% respectively. More accurately, APRI (cut-off > 0.63) or FIB-4 index (cut-off > 1.26) ruled out cirrhosis with high sensitivity of 94.4% and 88.9% and high negative predictive values of 98.1% and 96.3% respectively. In conclusion, APRI and FIB-4 index are simple readily avail-able markers to exclude significant fibrosis or more accurately cirrhosis in black African patients with CHB.