scholarly journals Transient Elastography for Significant Liver Fibrosis and Cirrhosis in Chronic Hepatitis B: A Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-13 ◽  
Author(s):  
Xiaolong Qi ◽  
Min An ◽  
Tongwei Wu ◽  
Deke Jiang ◽  
Mengyun Peng ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Diagnostic Accuracy ◽  
Chronic Hepatitis B ◽  
Transient Elastography ◽  
Meta Analysis ◽  
Receiver Operating Curve ◽  
Significant Fibrosis ◽  
Receiver Operating

Background. The hepatitis B virus infection is a global health issue and the stage of liver fibrosis affects the prognosis in patients with chronic hepatitis B (CHB). We performed the meta-analysis describing diagnostic accuracy of transient elastography (TE) for predicting CHB-related fibrosis. Methods. We performed an adequate literature search to identify studies that assessed the diagnostic accuracy of TE in CHB patients using biopsy as reference standard. Hierarchical summary receiver-operating curves model and the bivariate mixed-effects binary regression model were applied to generate summary receiver-operating characteristic curves and pooled estimates of sensitivity and specificity. Results. The area under the summary receiver-operating curve for significant fibrosis and cirrhosis was 0.86 (95% confidence interval (CI): 0.83–0.89) and 0.92 (95% CI: 0.90–0.94), respectively. The sensitivity, specificity, and diagnostic odds ratio of TE for significant fibrosis were 0.78 (95% CI: 0.73–0.81, p<0.01; I2=85.59%), 0.81 (95% CI: 0.77–0.84, p<0.01; I2=88.20%), and 14.44 (95% CI: 10.80–19.31, p<0.01; I2=100%) and for cirrhosis were 0.84 (95% CI: 0.80–0.88, p<0.01; I2=76.67%), 0.87 (95% CI: 0.84–0.90, p<0.01; I2=90.89%), and 36.63 (95% CI: 25.38–52.87, p<0.01; I2=100%), respectively. The optimal cut-off values of TE were 7.25 kPa for diagnosing significant fibrosis and 12.4 kPa for diagnosing cirrhosis, respectively. Conclusion. TE is of great value in the detection of patients with CHB-related cirrhosis but has a suboptimal accuracy in the detection of significant fibrosis.

Diagnostic accuracy of transient elastography (FibroScan) versus the aspartate transaminase to platelet ratio index in assessing liver fibrosis in chronic hepatitis B: The role in primary care setting

2011 ◽  
Vol 64 (10) ◽  
pp. 916-920 ◽  
Author(s):  
C Rinaldi A Lesmana ◽  
Simon Salim ◽  
Irsan Hasan ◽  
Andri S Sulaiman ◽  
Rino A Gani ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Diagnostic Accuracy ◽  
Chronic Hepatitis B ◽  
Care Setting ◽  
Primary Care Setting ◽  
Transient Elastography ◽  
Liver Stiffness

BackgroundA non-invasive method to assess liver fibrosis by measuring liver stiffness with transient elastography (TE) has been recently introduced. The role of TE among chronic hepatitis B (CHB) patients in starting antiviral therapy in the primary care setting is still controversial because of its high cost. The AST to platelet ratio index (APRI) could be a much cheaper alternative.ObjectivesThis study compares the diagnostic accuracy of TE and APRI in assessing liver fibrosis in CHB patients.Patients and MethodsA cross-sectional study in CHB patients intending to start antiviral treatment. Liver fibrosis was staged according to the METAVIR scoring system. Liver stiffness was measured by TE performed on the same day with liver biopsy, while APRI was calculated as follows: APRI=(AST/upper limit of normal)×100/platelet count (109/l). Cutoff levels of liver stiffness and APRI were calculated by using the receiver operating characteristic curve to detect significant liver fibrosis, defined as fibrosis stage F2 or more.Results117 patients were enrolled in the study; their mean age was 40.6±10.97 years. The median liver stiffness was 5.9 kPa (2.5–48 kPa) and the median APRI was 0.239 (0.09–2.73). The cutoff level of liver stiffness was 5.85 kPa for ≥F2 with an AUC of 0.614, 60.3% sensitivity, 63.6% specificity, 73.3% PPV, 49.1% NPV and a LR+ of 1.66. The APRI cutoff level was 0.235 for F≥2 with an AUC of 0.693, 64.4% sensitivity, 70.5% specificity, 78.3% PPV, 54.4% NPV and a LR+ of 2.18. Both methods gave comparable diagnostic accuracy.ConclusionAPRI is a useful marker to screen liver fibrosis in the primary care setting when TE is not available.

scholarly journals Performance of Transient Elastography for the Staging of Liver Fibrosis in Patients with Chronic Hepatitis B: A Meta-Analysis

PLoS ONE ◽  
2012 ◽  
Vol 7 (9) ◽  
pp. e44930 ◽  
Author(s):  
Young Eun Chon ◽  
Eun Hee Choi ◽  
Ki Jun Song ◽  
Jun Yong Park ◽  
Do Young Kim ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Transient Elastography ◽  
Meta Analysis

scholarly journals Prevalence and Determinants of Significant Liver Fibrosis by Vibration-Controlled Transient Elastography in Thai Chronic Hepatitis B Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Apichet Sirinawasatien ◽  
Thanaya Techasirioangkun ◽  
Siriporn Thongsri
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B Virus ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Transient Elastography ◽  
Male Gender ◽  
Significant Fibrosis ◽  
B Virus ◽  
Significant Liver Fibrosis

Aims. To describe the prevalence of significant liver fibrosis by ultrasound-based vibration-controlled transient elastography (VCTE; FibroScan®) and to identify the determinants of significant liver fibrosis in Thai chronic hepatitis B patients. Methods. A cross-sectional study of consecutive chronic hepatitis B patients performed VCTE and followed up at Rajavithi Hospital, Bangkok, Thailand, was conducted between 1 January, 2013, and 31 December, 2016. Liver fibrosis was defined as minimal (METAVIR F0-1) by VCTE < 7.2 kPa and significant (METAVIR F2-4) by VCTE ≥ 7.2 kPa. VCTE assessments and medical records were retrospectively reviewed. The prevalence and determinants of significant liver fibrosis were analyzed. Results. A total of 206 eligible patients were included; 120 patients (58.3%) were female. The mean age was 50 years (SD 12.4 years), and 32.5% had a body mass index ≥ 25. The prevalences of minimal (F 0-1) and significant fibrosis (F2-4) were 74.3% and 25.7%, respectively. The prevalence of hepatitis B e antigen negative (HBeAg -ve) was 83%. The median serum hepatitis B virus viral load was 4,340 IU/mL (range 20-271,883,036). Significant determinants of significant fibrosis (F2-4) were male gender (aOR 3.24 [95%CI: 1.36-7.72]) and high aspartate transaminase (AST) level (aOR 5.71 [95%CI: 2.03-16.04]). Conclusion. Around one-quarter of the Thai patients with chronic viral hepatitis B had significant liver disease defined by VCTE, requiring further evaluation for specific treatment for hepatitis B virus. Determinants of significant liver fibrosis were male gender and high AST level.

Role of serum M2BPGi levels in diagnosing significant liver fibrosis and cirrhosis in patients with chronic hepatitis B

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Marcel William Keddeas ◽  
Hany Haroun Kaisar ◽  
Hagar Ahmed Ahmed Elessawy ◽  
Mariam Samir Abdel Hamid Elewa
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Serum Level ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Protein Glycosylation ◽  
Control Group ◽  
Serum Samples

Abstract Background and aim Mac-2-binding protein glycosylation isomer (M2BPGi) is a novel serum diagnostic marker for liver fibrosis in various liver diseases. We aimed to evaluate its role in assessment of liver fibrosis in chronic hepatitis B infection (CHB) with reference to liver stiffness measurement (LSM) by transient elastography (Fibroscan). Design and Methods A case control study. 50 CHB patients with LSM by transient elastography technology and retrievable serum samples and 20 normal volunteers as a control group were recruited. Results 50 CHB patients (M: F = 30:20; mean age 43years ± 10.58) and 20 normal control volunteers (M: F = 12:8; mean age 37years ± 14.5) were recruited. The mean M2BPGi values for control group, F0-F1, F2, F3 and F4 progressively increased with more advanced stages of liver fibrosis: 0.282, 0.719, 1.322, 1.65 and 1.904 COI, respectively (p &lt; 0.001). M2BPGi levels correlated well with liver stiffness (r = 0.911) and moderately with FIB-4 (r = 0.682), and with APRI (r = 0.536) (all p &lt; 0.001). Using cut-off values of 0.455, 1.02, 1.16, 1.66 and 1.71COI for control, F0-F1, F2, F3 and F4 groups, respectively, the AUROCs were 0.996, 0.996, 0.691, 0.794 and 1.00 for control, F0-F1, F2, F3 and F4 groups, respectively. There was a statistically significant but with weak positive correlation between M2BPGi serum level and INR (r = 0.333, p = 0.018). And there was a statistically significant but with weak negative correlation between M2BPGi serum level and platelet count (r = -0.41, p = 0.003) and HBV DNA (r = -0.373, p = 0.008).There was a statistically significance between M2BPGi serum level and the history of varices (p = 0.023) Conclusions WFA+-M2BP is an accurate serum indicator for assessing different stages of liver fibrosis. WFA+-M2BP provides a simple and reliable alternative or complementary method to liver biopsy and FibroScan.

scholarly journals Clinical Significance of Quantitative HBs Antigen in the Prediction of Liver Fibrosis in Patients with Chronic Hepatitis B

PRILOZI ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 51-58
Author(s):  
Marija Dimzova ◽  
Irena Kondova-Topuzovska ◽  
Zvonko Milenkovic ◽  
Magdalena Gaseva ◽  
Viktorija Chaloska-Ivanova ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Clinical Significance ◽  
Transient Elastography ◽  
Hepatitis B Surface Antigen ◽  
Fisher Exact Test ◽  
Hbs Antigen ◽  
Negative Chronic Hepatitis

Abstract The assessment of liver fibrosis in patients with chronic hepatitis B (CHB) is of great importance in evaluating the phases of chronic hepatitis B viral infection, prompt administration of antiviral therapy, prevention of disease progression and late complications of CHB infection. Aim: to investigate the clinical significance of quantitative HBs antigen as a predictor for liver fibrosis in patients with HBe antigen negative chronic hepatitis B and inactive carriers. Material and Methods: the study included 44 treatment naïve patients with chronic hepatitis B, divided into two groups, HBeAg negative chronic HBV infection or inactive carriers (IC) and HBeAg negative chronic hepatitis B patients. All patients underwent laboratory, serologic testing, ultrasound and transient elastography (TE). In both patient groups, quantitative HBs antigen (HBsQ), alanine aminotransferase (ALT), hepatitis B virus deoxyribonucleic acid (HBV DNA) and liver fibrosis were analyzed. Results: The value of HBsQ is significantly higher in patients with HBeAg negative CHB 2477.02±4535.44 IU/ml than in the IC group 8791±11891 IU/ml; Z=3.32, p<0.001 (p=0.0009). In IC patients, 1 (4.76%) had fibrosis and 20 (95.24%)) did not have fibrosis. Out of 23 patients with HBeAg negative chronic hepatitis B, 8 (34.78%) had fibrosis and 15 (65.22%) did not have fibrosis. Patients with HBeAg negative hepatitis B had significantly higher liver fibrosis than IC; Fisher Exact Test p<0.05 (p=0.02). The increase of HBsQ for one single unit (IU/ml) does not have predictive value for fibrosis (Ext (B) =1.00), 95% C.I. for EXP (B): 1.00-1.00 / p>0.05. Conclusion: Quantitative hepatitis B surface antigen has intermediate weak statistically insignificant prediction for liver fibrosis R=0.25 (p<0.10).

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