Combination of Transient Elastography and an Enhanced Liver Fibrosis Test to Assess the Degree of Liver Fibrosis in Patients with Chronic Hepatitis B
نویسندگان
چکیده
Background/Aims Liver stiffness (LS) was assessed using transient elastography, and the enhanced liver fibrosis (ELF) test was performed to accurately assess fibrotic burden. We validated the LS-ELF algorithm and investigated whether the sequential LS-ELF algorithm performs better than concurrent combination of these analyses in chronic hepatitis B (CHB) patients. Methods Between 2009 and 2013, 222 CHB patients who underwent liver biopsy (LB), as well as LS measurement and the ELF test, were enrolled. Results Advanced fibrosis (≥F3) and cirrhosis (F4) were identified in 141 (63.6%) and 118 (53.2%) patients, respectively. Areas under receiver operating characteristic curve for LS predictions of ≥F3 (0.887 vs 0.703) and F4 (0.853 vs 0.706) were significantly higher than the ELF test (all p<0.001). Based on the LS-ELF algorithm, 60.4% to 71.6% and 55.7% to 66.3% of patients could have avoided LB to exclude ≥F3 and F4, respectively, whereas 68.0% to 78.7% and 63.5% to 66.1% of patients could have avoided LB to confirm ≥F3 and F4, respectively. When confirmation and exclusion strategies were applied simultaneously, 69.4% to 72.5% and 60.8% to 65.3% of patients could have avoided LB and been diagnosed as ≥F3 and F4, respectively. The proportion of patients who correctly avoided LB for the prediction of ≥F3 (69.4% to 72.5% vs 42.3% to 59.0%) and F4 (60.8% to 65.3% vs 23.9% to 49.5%) based on the sequential LS-ELF algorithm was significantly higher than the concurrent combination (all p<0.05). Conclusions The sequential LS-ELF algorithm conferred a greater probability of avoiding LB in CHB patients to diagnose advanced fibrosis and cirrhosis, and this test performed significantly better than the concurrent combination.
منابع مشابه
Assessment of transient elastography (FibroScan) for diagnosis of fibrosis in non-alcoholic fatty liver disease: A systematic review and meta-analysis
Background: Transient elastography (TE) is a new modality for the diagnosis of liver fibrosis caused by various etiologies. This study was conducted to determine the accuracy of TE in detecting the different stages of liver fibrosis in non-alcoholic fatty liver disease (NAFLD) patients. Methods: MEDLINE/PubMed, Embase, Ovid, Cochrane Library, American College of Physicians (ACP) Journal Club...
متن کاملDetermining the progression stages of liver fibrosis in patients with chronic hepatitis B
Introduction: Chronic hepatitis B (CHB) leads to liver fibrosis, its failure, and death in the long term. The stage of fibrosis in CHB patients can also be detected based on the biochemical markers. The aim of this study was to predict the state of liver fibrosis in CHB patients and determine the possibility of patients shifting from a given state to another one. Materials and Methods: This stu...
متن کاملبررسی عوامل مرتبط با شدت فیبروز کبد در بیماران مبتلا به هپاتیتهای مزمن B و C
Background & Aim: Viral hepatitis has existed since the creation of human. The estimated prevalence of hepatitis is about 3-5%. For patients with chronic hepatitis C and moderate to severe liver fibrosis, antiviral therapy is strongly suggested, while the cases without fibrosis or with mild liver fibrosis are often followed up without receiving antiviral therapy. The purpose of the present s...
متن کاملAssessment of hepatic fibrosis by transient elastography in rheumatoid arthritis patients receiving methotrexate
Background and Aim: Methotrexate (MTX) is commonly used in the treatment of diseases such as rheumatoid arthritis (RA) but, its hepatotoxicity potential, always has been a major concern. The aim of this study is to determine the rate of liver fibrosis by transient elastography (TE) method and its relationship with cumulative dose of MTX and duration of treatment, in rheumatoid arthritis patient...
متن کاملThe 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 fi...
متن کامل