Serum aminotransferase levels instead of etiology affects the accuracy of transient elastography in chronic viral hepatitis patients

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http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2010.06419.x/abstract

Serum aminotransferase levels instead of etiology affects the accuracy of

transient elastography in chronic viral hepatitis patients

Hye Jin Cho1, Yeon Seok Seo1,*, Kwang Gyun Lee1, Jong Jin Hyun1, Hyonggin An2,

Bora Keum1, Ji Hoon Kim1, Hyung Joon Yim1, Yoon Tae Jeen1, Hong Sik Lee1, Hoon

Jai Chun1, Soon Ho Um1, Chang Duck Kim1, Ho Sang Ryu1

Article first published online: 28 JUN 2010

DOI: 10.1111/j.1440-1746.2010.06419.x

© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell

Publishing Asia Pty Ltd

Issue

Journal of Gastroenterology and Hepatology

Volume 26, Issue 3, pages 492–500, March 2011

Abstract

Background and Aim:  It is still uncertain whether the accuracy of transient

elastography (TE) in predicting the fibrosis stage is similar in chronic

hepatitis B (CHB) and chronic hepatitis C (CHC). The present study was carried

out to evaluate whether the underlying cause of chronic viral hepatitis affects

the predictive accuracy of TE.

Methods:  Patients with CHB or CHC who were admitted for a liver biopsy were

enrolled. Patients underwent TE and laboratory tests on the same day as the

liver biopsy. The predictive accuracy was analyzed by comparing the areas under

the receiver-operating characteristic curves (AUCs).

Results:  Two-hundred and seven patients were enrolled, comprising 121 CHB

patients and 86 CHC patients). The patients were aged 44 ± 14 years, and 121

(58.5%) of them were men. AUCs for predicting significant fibrosis were

significantly lower in CHB patients than in CHC patients (P = 0.043). The serum

alanine aminotransferase (ALT) level was associated with overestimation and

underestimation of the fibrosis stage, while the cause of chronic hepatitis was

not. AUCs for predicting significant fibrosis were significantly lower in

patients with ALT levels >70 IU/L (AUC, 0.830; 95% CI, 0.742–0.898) than in

patients with ALT levels ≤70 IU/L (0.944; 0.882–0.979; P = 0.015).

Conclusions:  Although the predictive accuracy of TE in predicting significant

fibrosis differed significantly with the cause of chronic hepatitis, this

difference was due to the degree of serum ALT levels rather than to the cause of

hepatitis itself. Avoiding performing TE in patients with elevated ALT levels is

recommended to guarantee the predictive accuracy of TE.