Fibroscan improves the diagnosis sensitivity of liver fibrosis in patients with chronic hepatitis B

Abstract

The aim of the present study was to investigate the diagnostic accuracy of Fibroscan for liver fibrosis in patients with chronic hepatitis B (CHB) with alanine aminotransferase (ALT) levels <2 times the upper normal limit. A total of 263 consecutive patients with CHB and ALT levels <2 times the upper normal limit were enrolled in the present study. Liver biopsies and liver stiffness measurements (LSM) were conducted. Receiver operating characteristic (ROC) analysis was used to determine the predictive ability of LSM for the development of liver fibrosis in patients with stage S1, S2 and S3 liver fibrosis. Bivariate Spearman rank correlation analysis was performed in order to determine the association between liver stiffness value, which was measured by Fibroscan, and liver fibrosis stage, which was measured by liver biopsy. The liver stiffness value was found to be positively correlated with the liver fibrosis stage (r=0.522, P<0.001) and necroinflammatory activity (r=0.461, P<0.001), which was measured by liver biopsy. The optimal cut-off value in the patients with stage S1, S2 and S3 liver fibrosis was 5.5, 8.0 and 10.95 kPa, respectively. The area under the ROC curve for the prediction of the development of liver fibrosis in these patients was 0.696, 0.911 and 0.923, respectively. The threshold of the optimal cut-off value exhibited a high sensitivity and specificity. The results of the present study suggested that Fibroscan may improve the sensitivity of the diagnosis of liver fibrosis in patients with CHB and ALT levels <2 times the upper normal limit, and that this sensitivity may increase with the progression of liver fibrosis.

Diagnostic value of FIB-4, aspartate aminotransferase-to-platelet ratio index and liver stiffness measurement in hepatitis B virus-infected patients with persistently normal alanine aminotransferase

“…The invasiveness of liver puncture, the limitation of the specimen, and the poor patient compliance have restricted the application of LB, which has led to the development of noninvasive methods such as FIB-4[ 13 ] and aspartate aminotransferase (AST)-to-platelet ratio index (APRI)[ 14 ] for evaluating fibrosis in patients with chronic HBV infection. Liver stiffness measurement (LSM) using transient elastography (FibroScan) has been widely used in the diagnosis of chronic liver fibrosis[ 15 , 16 ]. However, the diagnostic value of FIB-4, APRI, and LSM in patients with HBV infection with PNALT is not clear.…”

Exploring patient characteristics and barriers to Hepatitis C treatment in patients on opioid substitution treatment attending a community based fibro-scanning clinic

“…Liver biopsy whilst evident as the gold standard of liver fibrosis is difficult, invasive and costly. [34] Liver stiffness measurement (LSM) using fibroscan is increasingly being used to assess disease severity. [35] This procedure can help to enhance HCV assessment, reduce treatment barriers, triage patients and target therapy.…”

Fibrosis assessment in patients with chronic hepatitis B virus (HBV) infection

“…A recent study showed the utility of TE for the diagnosis of fibrosis in 263 HBV patients with ALT levels <2× upper limit of normal (ULN), particularly in those with at least significant underlying fibrosis. LS value was also found to correlate significantly with both liver fibrosis and necroinflammatory activity on biopsy, a consideration for the interpretation of TE measurements (104). Some authors have suggested that TE cut-offs should incorporate ALT levels which fluctuate with inflammation in HBV, and TE may be particularly useful HbeAg-negative patients with normal LFTs to guide the need for biopsy of treatment (105).…”