Transient Elastography is Superior to the FIB 4 Index, Aspartate Platelet Ratio Index, Aspartate Alanine Aminotransferase Ratio, Age Platelet Index and Fibrosis Index in Diagnosing Fibrosis in Chronic Hepatitis B Patients-Advanced Research in Gastroenterology & Hepatology-Juniper Publishers

 

JUNIPER PUBLISHERS-Advanced Research in Gastroenterology & Hepatology


Transient Elastography Is Superior To The Fib 4 Index, Aspartate Platelet Ratio Index, Aspartate Alanine Aminotransferase Ratio, Age Platelet Index And Fibrosis Index In Diagnosing Fibrosis In Chronic Hepatitis B Patients

Authored by Raymond Kwok


Introduction: Transient Elastography is a promising form of non-invasive assessment of fibrosis in chronic hepatitis B. The diagnostic accuracy and usefulness of TE is evaluated and compared with FIB 4 index, Aspartate Platelet Ratio Index (APRI), Aspartate Alanine aminotransferase Ratio (AAR), Age Platelet Index (API) and Fibrosis Index (FI).

Methods: Chronic hepatitis B patients who had a liver biopsy within the past 6 months were identified and invited to have TE. Clinical history, laboratory data and pathology were collected TE was performed as per the manufacturer’s instructions. At least 10 successful measurements were required for a valid Liver Stiffness Measurement (LSM). An interquartile range to median ratio of < 30% was required when the LSM≥7.1 kPa for a reliable LSM. A second histology assessment was performed on liver biopsies slides that were available.

Results: 71 patients were recruited. LSM Area Under Receiver Operator Characteristic (AUROC) curves for F≥1, 2, 3 and 4 were 0.825 (95% CI 0.728-0.922, p< 0.001), 0.792 (95% CI 0.689-0.895, p< 0.001), 0.874 (95% CI 0.775-0.973, p< 0.001) and 0.945 (95% CI 0.867-1.000, p=0.001) respectively. Using ALT level specific LSM Cut-offs, F≥2 and F≥3 can be diagnosed or excluded with a very high degree of certainty (>90%) in 49.3% and 57.7% respectively. TE was the most superior non-invasive measure for every stage of fibrosis when compared with FIB-4I, APRI, API, AAR and FI.

Conclusions: TE has excellent accuracy for F4 and F≥3 and can reduce the need for liver biopsies in the majority of chronic hepatitis B patients.



 
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