Evaluation of transient elastography for fibrosis assessment compared with large biopsies in chronic hepatitis B and C

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02663.x/abstract

Evaluation of transient elastography for fibrosis assessment compared with large

biopsies in chronic hepatitis B and C

Verveer1, Pieter E. Zondervan2, Fibo J. W. ten Kate2, Bettina E.

Hansen1,3, Harry L. A. Janssen1, J. de Knegt1,

*Article first published online: 17 OCT 2011

DOI: 10.1111/j.1478-3231.2011.02663.x

¿ 2011 Wiley & Sons A/S

Issue

Liver International

Early View (Online Version of Record published before inclusion in an issue)

Abstract

Background

Fibrosis determines prognosis and management in patients with chronic hepatitis

B and C (CHB and CHC). Transient elastography (TE) is a promising non-invasive

method to assess fibrosis. We prospectively studied the performance of TE

compared to histology and also whether there are differences between CHB and

CHC. Only large biopsies (™25 mm) were used.

Methods

We included 241 patients with CHB (n = 125) and CHC (n = 116), of whom we

acquired 257 liver biopsies, all preceded by elastography. We correlated liver

stiffness with fibrosis stage according to the METAVIR system, inflammation

(Histology Activity Index), steatosis and iron. The impact of gender, age, body

mass index, alcohol, alanine aminotransferase levels, platelet count, viral load

and genotype on liver stiffness was evaluated.

Results

The AUROC's for F ™ 2 were 0.85 for CHB and 0.76 for CHC. AUROC's for F ™ 3 were

0.91 for CHB and 0.87 for CHC and 0.90 and 0.91 for F4 for CHB and CHC

respectively. For F ™ 2 the cut-off value was 6.0 kPa for CHB and 5.0 kPa for

CHC. The cut-off values for ™F3 were 9.0 and 8.0 kPa for CHB and CHC,

respectively, and 13.0 kPa for F4 in both CHB and CHC patients. Besides

inflammation, all other remaining factors do not influence liver stiffness.

Conclusion

For the diagnosis of fibrosis stages F ˜ 2 TE is suboptimal, and inflammation

may induce higher values. For stages F ™ 3 TE performance is good and equal in

both CHB and CHC patients.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02663.x/abstract

Evaluation of transient elastography for fibrosis assessment compared with large

biopsies in chronic hepatitis B and C

Verveer1, Pieter E. Zondervan2, Fibo J. W. ten Kate2, Bettina E.

Hansen1,3, Harry L. A. Janssen1, J. de Knegt1,

*Article first published online: 17 OCT 2011

DOI: 10.1111/j.1478-3231.2011.02663.x

¿ 2011 Wiley & Sons A/S

Issue

Liver International

Early View (Online Version of Record published before inclusion in an issue)

Abstract

Background

Fibrosis determines prognosis and management in patients with chronic hepatitis

B and C (CHB and CHC). Transient elastography (TE) is a promising non-invasive

method to assess fibrosis. We prospectively studied the performance of TE

compared to histology and also whether there are differences between CHB and

CHC. Only large biopsies (™25 mm) were used.

Methods

We included 241 patients with CHB (n = 125) and CHC (n = 116), of whom we

acquired 257 liver biopsies, all preceded by elastography. We correlated liver

stiffness with fibrosis stage according to the METAVIR system, inflammation

(Histology Activity Index), steatosis and iron. The impact of gender, age, body

mass index, alcohol, alanine aminotransferase levels, platelet count, viral load

and genotype on liver stiffness was evaluated.

Results

The AUROC's for F ™ 2 were 0.85 for CHB and 0.76 for CHC. AUROC's for F ™ 3 were

0.91 for CHB and 0.87 for CHC and 0.90 and 0.91 for F4 for CHB and CHC

respectively. For F ™ 2 the cut-off value was 6.0 kPa for CHB and 5.0 kPa for

CHC. The cut-off values for ™F3 were 9.0 and 8.0 kPa for CHB and CHC,

respectively, and 13.0 kPa for F4 in both CHB and CHC patients. Besides

inflammation, all other remaining factors do not influence liver stiffness.

Conclusion

For the diagnosis of fibrosis stages F ˜ 2 TE is suboptimal, and inflammation

may induce higher values. For stages F ™ 3 TE performance is good and equal in

both CHB and CHC patients.