Serum hepatitis <scp>B</scp> surface antigen quantification as a useful assessment for significant fibrosis in hepatitis <scp>B</scp> e antigen‐positive hepatitis <scp>B</scp> virus carriers

Xun, Yunhao; Zang, Guoqing; Guo, Jiao; Yu, Xiuli; Liu, Hong; Xiang, Jianyang; Liu, Jing; Shi, Junping

doi:10.1111/jgh.12304

Cited by 26 publications

(26 citation statements)

References 51 publications

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“…ΔThe disease spectrum of some studies [11], [17], [19]–[21], [24], [26]–[28] were not in good accordance with our study, thus they were excluded for sensitivity analysis.…”

Section: Resultsmentioning

confidence: 89%

“…Despite this limitation, these factors were assessed in meta-regression for exploring sources of heterogeneity. The disease spectrum of 9 studies [11], [17], [19]–[21], [24], [26]–[28] were not in good accordance with our study and were excluded for further sensitivity analysis. Specifically, three of these studies [20], [24], [27] focused on patients with limited ALT (normal or less than 2× upper limit of normal), one focused on Hepatitis B virus e antigen (HBeAg)-positive patients [28], one focused on HBeAg-negative patients [26], one defined the urea nitrogen limitation when collecting samples [11], one included patients after therapy [19], one only included inpatients [17], and one did not describe the objective of the study clearly [21].…”

Section: Resultsmentioning

confidence: 97%

“…The bias of index test was mainly because many studies didn’t predefine the cutoff value. Five studies were found to have a disease progression bias [18], [19], [21], [29], [30], and nine studies did not describe whether interpretation of liver biopsy specimens was blinded to other test results [16], [17], [21]–[23], [28]–[30], [32].…”

Section: Resultsmentioning

confidence: 99%

“…ΔThe disease spectrum of some studies [11], [17], [19]–[21], [24], [26]–[28] were not in good accordance with our study, thus they were excluded for sensitivity analysis.*The studies in which the reference standard results were interpreted without knowledge of the results of the index tests, were grouped into “Blindness”.The “proper interval” was defined as the time interval between the determination of the FIB-4 index and liver biopsy was no longer than 7 days.#As two studies [22], [32] were written by the same author, the study [32] with the smaller sample size was excluded for sensitivity analysis. 95% CI: 95% confidence interval.…”

Section: Resultsmentioning

confidence: 99%

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The Diagnostic Value of the FIB-4 Index for Staging Hepatitis B-Related Fibrosis: A Meta-Analysis

Chen

Zhao

2014

PLoS ONE

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BackgroundLiver fibrosis stage is an important factor in determining prognosis and need for treatment in patients infected with hepatitis B virus (HBV). Liver biopsies are typically used to assess liver fibrosis; however, noninvasive alternatives such as the FIB-4 index have also been developed.AimsTo quantify the accuracy of the FIB-4 index in the diagnosis of HBV related fibrosis and cirrhosis.MethodsA meta-analysis of studies comparing the diagnostic accuracy of the FIB-4 index vs. liver biopsy in HBV-infected patients was performed using studies retrieved from the following databases: PubMed, Ovid, EMBASE, the Cochrane Library, the Chinese National Knowledge Infrastructure and the Chinese Biology Medicine disc. A hierarchical summary receiver operating curves model and bivariate model were used to produce summary receiver operating characteristic curves and pooled estimates of sensitivity and specificity. The heterogeneity was explored with meta-regression analysis. Publication bias was detected using Egger’s test and the trim and fill method.Results12 studies (N = 1,908) and 10 studies (N = 2,105) were included in the meta-analysis for significant fibrosis and cirrhosis, respectively. For significant fibrosis, the area under the hierarchical summary receiver operating curve (AUHSROC) was 0.78 (95% CI = 0.74–0.81). The recommended cutoff value was between 1.45 and 1.62, and the AUHSROC, summary sensitivity and specificity were 0.78 (95% CI = 0.74–0.81), 0.65 (95% CI = 0.56–0.73) and 0.77 (95% CI = 0.7–0.83), respectively. For cirrhosis, the AUHSROC was 0.89 (95% CI = 0.85–0.91). The recommended cutoff value was between 2.9 and 3.6, and the AUHSROC, summary sensitivity and specificity were 0.96 (95% CI = 0.92–1.00), 0.42 (95% CI = 0.36–0.48) and 0.96 (95% CI = 0.95–0.97), respectively. No publication bias was detected.ConclusionsThe FIB-4 index is valuable for detecting significant fibrosis and cirrhosis in HBV-infected patients, but has suboptimal accuracy in excluding fibrosis and cirrhosis.

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“…ΔThe disease spectrum of some studies [11], [17], [19]–[21], [24], [26]–[28] were not in good accordance with our study, thus they were excluded for sensitivity analysis.…”

Section: Resultsmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

The Diagnostic Value of the FIB-4 Index for Staging Hepatitis B-Related Fibrosis: A Meta-Analysis

Chen

Zhao

2014

PLoS ONE

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“…For instance, Demiroren et al conducted a study on 56 HBeAg positive patients receiving interferon alpha 2b treatment and found no meaningful relationship between qHBsAg level and fibrosis degree (30). Contrary to what was noted in that study, it was demonstrated that qHBsAg levels specifically identified significant fibrosis in treatment-naive HBeAg-positive HBV carriers in another study conducted with a larger patient group (31). In another investigation carried out by Farnik et al with analogs of nucleotides and nucleosides, the M-30 apoptosis epitope and its quantitative levels before and after treatment were evaluated, and a significant decrease in HBV DNA parallel to qHBsAg was observed at the 24th week of treatment.…”

mentioning

confidence: 76%

Clinical Usefulness of HBsAg Quantification in Patients with Chronic Hepatitis B Infection

Karagöz

Tanoğlu

2017

Hepat Mon

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Context: Quantitative hepatitis B surface antigen (qHBsAg) levels have been shown to assist the management of patients with chronic hepatitis B virus (HBV) infection and reflect the level of transcriptional activity of covalently closed circular DNA (cccDNA). It has been indicated the importance of co-operative use of qHBsAg and HBV-DNA for diagnosis and monitoring of CHB treatment. Evidence Acquisition: In order to achieve a comprehensive approach in HBsAg quantification, an extensive search was done using relevant keywords in major medical libraries to collect, categorize, and summarize data in different sections. Results: A combination of qHBsAg < 1000 IU/mL and HBV-DNA < 2000 IU/mL can identify inactive carriers. qHBsAg levels are changed during the natural history of HBV infection that progressively declines from the immune tolerance to the inactive phase. Conclusions:The use of qHBsAg in chronic hepatitis B (CHB) patients may bring about important complementary information regarding HBV DNA during treatment and help predict the treatment outcome.

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Comparison of diagnostic accuracy of aspartate aminotransferase to platelet ratio index and fibrosis‐4 index for detecting liver fibrosis in adult patients with chronic hepatitis B virus infection: A systemic review and meta‐analysis

2014

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The aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis index based on the four factors (Fibrosis 4 index; FIB-4) are the two most widely studied noninvasive tools for assessing liver fibrosis. Our aims were to systematically review the performance of APRI and FIB-4 in hepatitis B virus (HBV) infection in adult patients and compare their advantages and disadvantages. We examined the diagnostic accuracy of APRI and FIB-4 for significant fibrosis, advanced fibrosis, and cirrhosis based on their sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUROC). Heterogeneity was explored using metaregression. Our systemic review and meta-analysis included 16 articles of APRI only, 21 articles of APRI and FIB-4 and two articles of FIB-4 for detecting different levels of liver fibrosis. With an APRI threshold of 0.5, 1.0, and 1.5, the sensitivity and specificity values were 70.0% and 60.0%, 50.0% and 83.0%, and 36.9% and 92.5% for significant fibrosis, advanced fibrosis, and cirrhosis, respectively. With an FIB-4 threshold of 1.45 and 3.25, the sensitivity and specificity values were 65.4% and 73.6% and 16.2% and 95.2% for significant fibrosis. The summary AUROC values using APRI and FIB-4 for the diagnosis of significant fibrosis, advanced fibrosis, and cirrhosis were 0.7407 (95% confidence interval [CI]: 0.7033-0.7781) and 0.7844 (95% CI: 0.7450-0.8238; (Z 5 1.59, P 5 0.06), 0.7347 (95% CI: 0.6790-0.7904) and 0.8165 (95% CI: 0.7707-0.8623; Z 5 2.01, P 5 0.02), and 0.7268 (95% CI: 0.6578-0.7958) and 0.8448 (95% CI: 0.7742-0.9154; (Z 5 2.34, P 5 0.01), respectively. Conclusions: Our meta-analysis suggests that APRI and FIB-4 can identify hepatitis B-related fibrosis with a moderate sensitivity and accuracy. (HEPATOLOGY 2015;61:292-302)

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Serum hepatitis B surface antigen quantification as a useful assessment for significant fibrosis in hepatitis B e antigen‐positive hepatitis B virus carriers

Abstract: Serum qHBsAg-based simple tests, especially GqHBsR, can accurately and specifically identify significant fibrosis in treatment-naïve HBeAg-positive HBV carriers.

Cited by 26 publications

References 51 publications

The Diagnostic Value of the FIB-4 Index for Staging Hepatitis B-Related Fibrosis: A Meta-Analysis

The Diagnostic Value of the FIB-4 Index for Staging Hepatitis B-Related Fibrosis: A Meta-Analysis

Clinical Usefulness of HBsAg Quantification in Patients with Chronic Hepatitis B Infection

Comparison of diagnostic accuracy of aspartate aminotransferase to platelet ratio index and fibrosis‐4 index for detecting liver fibrosis in adult patients with chronic hepatitis B virus infection: A systemic review and meta‐analysis

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