Declining diagnostic accuracy of non-invasive fibrosis tests is associated with elevated alanine aminotransferase in chronic hepatitis B

Figure 3 Relationship between serum alanine aminotransferase and the diagnostic accuracy of non-invasive fibrosis tests in chronic hepatitis B patients. A: Significant fibrosis (≥ S2); B: Advanced fibrosis (≥ S3); C: Cirrhosis (S4). The fibrosis stages are based on Scheuer’s classification. ALT: Alanine aminotransferase; GPR: Gamma-glutamyl transpeptidase (GGT)-to-platelet ratio; APRI: Aspartate aminotransferase (AST)-to-platelet (PLT) ratio index; FIB-4: Fibrosis index based on 4 factors.