The combination of 5 serum markers compared to FibroScan to predict significant liver fibrosis in patients with chronic hepatitis B virus

Dong, Huimin; Xu, Changzhi; Zhou, Wenying; Liao, Yuan; Cao, Junyan; Li, Zhaoxia; Hu, Bo

doi:10.1016/j.cca.2018.04.036

Cited by 23 publications

(15 citation statements)

References 23 publications

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“…A total of 2831 studies were searched by the described search strategies, of which 2627 were excluded following title and abstract screening. Of those, 81 papers were included in the review following full-text screening (Text S5); 47 studies were related to the APRI[24-70], 11 to the ARFI[29,42,69-77], 32 to the FIB-4[24,25,27,30,35,36,39,40,43-46,48-55,57,58,60,62,63,65-69,78-79], 29 to the FibroScan[28,38,42,52,53,58,60,61,71,73,80-98], and 6 to the MRE[99-104].…”

Section: Resultsmentioning

confidence: 99%

Performance of common imaging techniques vs serum biomarkers in assessing fibrosis in patients with chronic hepatitis B: A systematic review and meta-analysis

Xue¹,

Wang²,

Zhang³

et al. 2019

WJCC

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BACKGROUND Noninvasive biomarkers have been developed to predict hepatitis B virus (HBV) related fibrosis owing to the significant limitations of liver biopsy. Both serum biomarkers and imaging techniques have shown promising results and may improve the evaluation of liver fibrosis. However, most of the previous studies focused on the diagnostic effects of various imaging techniques on fibrosis in all chronic liver diseases. AIM To compare the performance of common imaging methods and serum biomarkers for prediction of significant fibrosis caused only by HBV infection. METHODS A systematic review was conducted on the records available in PubMed, EMBASE, and the Cochrane Library electronic databases until December 2018. We systematically assessed the effectiveness of two serum biomarkers and three imagine techniques in predicting significant fibrosis solely caused by HBV infection. The serum biomarkers included aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis index based on the 4 factors (FIB-4). The three imaging techniques included acoustic radiation force impulse (ARFI), FibroScan, and magnetic resonance elastography (MRE). Three parameters, the area under the summary receiver operating characteristic curve (AUSROC), the summary diagnostic odds ratio, and the summary sensitivity and specificity, were used to examine the accuracy of all tests for liver fibrosis. RESULTS Out of 2831 articles evaluated for eligibility, 204 satisfied the predetermined inclusion criteria for this current meta-analysis. Eventually, our final data contained 81 studies. The AUSROCs of serum biomarkers of APRI and FIB-4 were both 0.75. For imaging techniques (ARFI, FibroScan, and MRE), the areas were 0.89, 0.83, and 0.97, respectively. The heterogeneities of ARFI and FibroScan were statistically significant ( I 2 > 50%). The publication bias was not observed in any of the serum biomarkers or imaging methods. CONCLUSION These five methods have attained an acceptable level of diagnostic accuracy. Imaging techniques, MRE in particular, demonstrate significant advantages in accurately predicting HBV-related significant fibrosis, while serum biomarkers are admissible methods.

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Section: Resultsmentioning

confidence: 99%

Performance of common imaging techniques vs serum biomarkers in assessing fibrosis in patients with chronic hepatitis B: A systematic review and meta-analysis

Xue¹,

Wang²,

Zhang³

et al. 2019

WJCC

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“…Consequently, TE is becoming a widely accepted methodology for use in both clinical practice and in research [24,26,27].…”

Section: Discussionmentioning

confidence: 99%

Higher liver stiffness scores are associated with early kidney dysfunction in patients with histologically proven non-cirrhotic NAFLD

Sun

Kani

et al. 2020

Diabetes & Metabolism

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Aim: We examined the association between liver fibrosis (LF), assessed either by histology or by liver stiffness measurement (LSM), and the presence of early kidney dysfunction (EKD). We also investigated the diagnostic performance of LSM for identifying the presence of EKD in patients with nonalcoholic fatty liver disease (NAFLD). Materials and Methods: We studied 214 adults with non-cirrhotic biopsy-proven NAFLD recruited from two independent medical centers. Histologic stage of LF was quantified using the Brunt's criteria. Vibration-controlled transient elastography (TE) was performed in 154 patients and defined as significant when LSM was ≥8.0 kPa using the M probe (Fibroscan®). EKD was defined by the presence of microalbuminuria with an estimated glomerular filtration rate ≥60 ml/min/1.73m 2. Logistic regression modelling was undertaken to estimate the likelihood of having EKD with NAFLD (the LSM-EKD model). Results: The prevalence of EKD was higher in patients with LF than in those without LF on histology (22.14% vs. 4.82%, P<0.001). Similarly, the prevalence of EKD was higher in patients with LSM ≥8.0 kPa than in those with LSM <8.0 kPa (23.81% vs. 6.59%, P<0.05), and the area under the ROC curve of the LSM-EKD model for identifying EKD was 0.80 (95%CI 0.72-0.89). LF, detected by either method, was associated with EKD independently of established renal risk factors and potential confounders. Conclusions: LF is independently associated with EKD in patients with biopsy-proven NAFLD. TE-measured LSM is a widely used technique for quantifying LF, which accurately identifies those patients with NAFLD, who are at risk of having EKD.

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“…Despite the identification of its pathogenesis and antiviral therapeutic approaches, it accounts for nearly one million deaths per year around the world due to hepatic diseases, including chronic hepatitis, cirrhosis, fibrosis, and Hepatocellular Carcinoma (HCC) (2). Regarding Chronic Hepatitis B (CHB)infected cases, almost all instructions suggest not only to inhibit HBV replication when the level of alanine aminotransferase (ALT) is near the threshold for initiating treatment but also to monitor the degree of liver fibrosis (3).…”

Section: Introductionmentioning

confidence: 99%

“…Liver biopsy has been used as a reference to diagnose the liver fibrosis stage. Nonetheless, this technique is invasive, expensive, and associated with complications, sampling errors, and probable risks in clinical use (3,5). Therefore, the development of non-invasive approaches to evaluate liver fibrosis is recommended for improving the treatment of CHB and for the preparation of the liver biopsy (3,6).…”

Section: Introductionmentioning

confidence: 99%

Hepatic Arterial Blood Flow Index Is Associated with the Degree of Liver Fibrosis in Patients with Chronic Hepatitis B Virus Infection

Gao

Yin

et al. 2020

Hepat Mon

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Background: Liver fibrosis due to Hepatitis B Virus (HBV) infection is an important public health concern worldwide. An accurate assessment of liver fibrosis is crucial for the identification of susceptible patients to severe clinical conditions and selection of treatment for patients with Chronic Hepatitis B (CHB) infection. Today, the development of simple, accurate, cost-effective, and non-invasive liver fibrosis tests is essential in clinical practice. Methods: According to liver biopsy as the reference standard, we compared the efficacy of hepatic arterial blood flow index (HBI) versus liver stiffness measurement (LSM), aspartate aminotransferase-to-platelet count ratio index (APRI), and fibrosis index based on 4 factors (FIB-4) to predict various degrees of liver fibrosis among 87 patients with CHB infection. Results: Spearman’s rank correlation coefficient of HBI versus the degree of liver fibrosis, according to the METAVIR scoring system, was 0.672 (P < 0.001). The area under the receiver operating characteristic curve (AUROC) of HBI (0.884; 95% CI: 0.806 - 0.961; P = 0.000) was greater than that of LSM (0.807; 95% CI: 0.703 - 0.912; P = 0.00), APRI (0.684; 95% CI: 0.556 - 0.812; P = 0.009), and FIB-4 (0.757; 95% CI: 0.641 - 0.873; P = 0.000) for the diagnostic analysis of significant liver fibrosis (≥ F2); similar results were obtained for the prediction of other liver fibrosis stages. Conclusions: The present findings shed new light on the association of HBI with the degree of liver fibrosis in patients with CHB infection. Hepatic Arterial Perfusion Scintigraphy (HAPS) with the measurement of HBI is a promising diagnostic method of liver fibrosis stage, which can guide therapy in CHB patients, although further large-scale studies are needed.

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The combination of 5 serum markers compared to FibroScan to predict significant liver fibrosis in patients with chronic hepatitis B virus

Cited by 23 publications

References 23 publications

Performance of common imaging techniques vs serum biomarkers in assessing fibrosis in patients with chronic hepatitis B: A systematic review and meta-analysis

Performance of common imaging techniques vs serum biomarkers in assessing fibrosis in patients with chronic hepatitis B: A systematic review and meta-analysis

Higher liver stiffness scores are associated with early kidney dysfunction in patients with histologically proven non-cirrhotic NAFLD

Hepatic Arterial Blood Flow Index Is Associated with the Degree of Liver Fibrosis in Patients with Chronic Hepatitis B Virus Infection

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