Significance of Fibro Scan examination in hepatitis B virus-infected patients with normal ALT

Objective To screen hepatitis B virus( HBV)- infected patients with normal alanine aminotransferase( ALT) using Fibro Scan( FS). Methods Liver biopsy was done for all the 125 patients who were admitted to our hospitals from November 2012 to November 2013,and FS was performed for the liver stiffness measurement( LSM). Using the pathological inflammation grade from liver biopsy as a classification standard and G1 group as a control,a receiver operating characteristic( ROC) curve was plotted and the cut- off value was determined.Comparison of continuous data between multiple groups was made by Kruskal- Wallis H test,and comparison between two groups was made by Bonferroni test. Results The LSM of HBV- infected patients with the same stage of liver fibrosis was found to increase with the progression of liver inflammation; there were significant differences in LSM between groups with different grades of inflammation in each stage of liver fibrosis( S0- S2)( P < 0. 05),but no such differences were found between patients with inflammation grades G0 and G1( P > 0. 05).For≥G2 liver inflammation,the area under the ROC curve of FS was 0. 784,and the cut- off value determined by the ROC curve was 8. 64 k Pa,with 78. 6% sensitivity and 69. 2% specificity. Conclusion For HBV- infected patients with normal ALT,FS should be performed to decide whether further examination and treatment are needed. For patients with LSM≥8. 64 k Pa,liver biopsy should be performed; while for those with LSM < 8. 64 k Pa,regular examination is recommended.