Assessment of Liver Fibrosis Using Real-time Shear-wave Elastography for Patients with Hepatitis B e Antigen-negative Chronic Hepatitis B and Alanine Transaminase <2 Times the Upper Limit of Normal

Abstract

Background:We assessed liver fibrosis using real-time shear-wave elastography (SWE) combined with liver biopsy (LB) for patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) and alanine transaminase < 2 times the upper limit of normal and hepatitis B virus DNA < 2000 IU/ml. Methods: A total of 107 patients met the inclusion criteria. Real-time SWE and ultrasoundassisted liver biopsies were consecutively performed. Fibrosis was staged according to the METAVIR scoring system. Analyses of receiver operating characteristic curve were performed to calculate the optimal area under the receiver operating characteristic curve for F0-F1 versus F2-F4, F0-F2 versus F3-F4, and F0-F3 versus F4 for real-time SWE. Results: The most concurrent liver fibrosis degrees were between F1 and F2 for these HBeAg-negative CHB patients. Liver stiffness increased in parallel with the degree of liver fibrosis using SWE measurements. The area under the receiver operating characteristic curves was 0.881 (95% confidence interval [CI]: 0.704-1.000) for SWE (p = 0.004); 0.912 (95% CI: 0.836-0.987) for SWE (p = 0.000); 0.981 (95% CI: 0.956-1.000) for SWE (p = 0.000); 0.974 (95% CI: 0.936-1.000) for SWE (p = 0.000) when comparing F0 versus F1-F4, F0-F1 versus F2-F4, F0-F2 versus F3-F4, and F0-F3 versus F4, respectively. Conclusions: SWE has the advantage of providing an image of liver stiffness in real-time. As an alternative to LB, the development of all these noninvasive methods for dynamic evaluation of liver fibrosis will decrease the need for LB, making clinical care safer and more convenient for patients with liver diseases.

Two-dimensional shear wave elastography for significant liver fibrosis in patients with chronic hepatitis B: A systematic review and meta-analysis

“…After excluding non-original researches, studies not in the field of interest, non-English studies, etc., 27 full-text articles were downloaded for careful screening. Finally, eleven eligible studies with 2623 patients were included for narrative synthesis [27][28][29][30][31][32][33][34][35][36][37] and 9 studies including 1977 patients were selected for meta-analysis [28][29][30][31][32][34][35][36][37]. Table 1 summarizes the basic characteristics of the included studies.…”

“…Table 1 summarizes the basic characteristics of the included studies. Most studies were from China [27][28][29][30][31][33][34][35][36][37], while only 1 study came from Korea [32]. There were six prospective studies [27,30,33,[35][36][37] and 5 retrospective studies [28,29,31,32,34].…”

“…Most studies were from China [27][28][29][30][31][33][34][35][36][37], while only 1 study came from Korea [32]. There were six prospective studies [27,30,33,[35][36][37] and 5 retrospective studies [28,29,31,32,34]. Six studies recruited consecutive patients [27,29,30,34,36,37], while inconsecutive enrollments were found in 5 studies [28,[31][32][33]35].…”

“…There were six prospective studies [27,30,33,[35][36][37] and 5 retrospective studies [28,29,31,32,34]. Six studies recruited consecutive patients [27,29,30,34,36,37], while inconsecutive enrollments were found in 5 studies [28,[31][32][33]35]. The mean age of the patients was 43.6 years (range: 35.8-56.8 years).…”

“…Male patients accounted for approximately 73.9 % (range: 43.5 %-83.9 %) of all patients. Seven studies excluded patients with a history of prior antiviral therapy [27,30,32,33,[35][36][37], while 4 studies did not exclude patients who had received antiviral treatment [28,29,31,34]. Table 2 shows the technical characteristics of 2D-SWE.…”