The Association between Liver Fibrosis Measurement by Transient Elastography and Liver Biopsy in Chronic Hepatitis B Patients

Background: Transient Elastography (TE) is a noninvasive, reproducible tool to assess liver stiffness. Previous systemic review showed that liver stiffness measured by TE has high accuracy to detect histological liver fibrosis. However, few studies are looking at this relationship in patients with chronic hepatitis B (CHB). We aimed to assess the correlation between liver stiffness and liver fibrosis in Thai CHB patients. Patients and Methods: One hundred and four patients with CHB, mainly HBeAg negative, who underwent liver biopsy to assess liver histology before treatment at Siriraj Hospital from May 2007 to December 2007, were recruited. On the day of scheduled liver biopsy, complete liver tests and coagulogram were done. Liver stiffness was assessed by TE and expressed as kPa. Liver histology was evaluated and graded by METAVIR scoring system. The correlation between histological liver fibrosis and the liver stiffness was evaluated by the correlation statistics which describes the degree of relationship between both variables. Results: Liver stiffness significantly correlated with fibrosis stage (r = 0.52 p <0.00001). Areas under the receiver operating characteristic curve (AUROC) were 0.76 for patients with significant fibrosis (F≥2), and 0.79 for patients with severe fibrosis (F≥3). Cutoff value of 6.9 to detect significant fibrosis has a sensitivity, specificity, positive predictive value and negative predictive value of 70%, 79.5%, 82% and 66%, respectively. Conclusion: Liver stiffness measured by TE has an acceptable correlation with histological liver fibrosis in Thai CHB patients.