Value of liver stiffness measurement in the diagnosis of liver fibrosis degree in HBeAg-positive patients with chronic HBV infection

Liu Na; Li ChunXia; Dong Bing; Zhou LuLu; Zhang RuiQin; Zhao YingRen; He YingLi; Xu GuangHua

doi:10.3969/j.issn.1001-5256.2019.06.016

Volume 35 Issue 6

Jun. 2019

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Article Navigation > Journal of Clinical Hepatology > 2019 > 35(6): 1262-1265

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Value of liver stiffness measurement in the diagnosis of liver fibrosis degree in HBeAg-positive patients with chronic HBV infection

DOI: 10.3969/j.issn.1001-5256.2019.06.016

Department of Infectious Diseases, Affiliated Hospital of Yan'an University

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Received Date: 2019-01-14
Published Date: 2019-06-20

Abstract

Abstract

To investigate the value of liver stiffness measurement (LSM) in the diagnosis of liver fibrosis degree in HBeAg-positive patients with chronic HBV infection. Methods A retrospective analysis was performed for the clinical data of 330 HBeAg-positive patients with chronic HBV infection who were hospitalized in Affiliated Hospital of Yan'an University from October 2013 to August 2018 and underwent liver biopsy, and according to liver pathological results, these patients were divided into mild liver fibrosis group (F0-F1) and significant liver fibrosis group (F2-F4) . The t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. Univariate and multivariate analyses were performed to screen out the indices for the diagnosis of significant liver fibrosis, and the receiver operating characteristic (ROC) curve was plotted for these indices to evaluate their value in the diagnosis of significant liver fibrosis. Results Of all 330 patients, 245 had mild liver fibrosis and 85 had significant liver fibrosis. There were significant differences between the two groups in HBV DNA, HBsAg, HBeAg, HBcAb, alanine aminotransferase, aspartate aminotransferase, total bilirubin, and LSM (all P < 0. 05) . The multivariate analysis showed that HBsAg and LSM were independent risk factors for significant liver fibrosis (both P < 0. 05) . The ROC curve analysis showed that only LSM had a diagnostic value, with an area under the ROC curve of 0. 744 (95% confidence interval: 0. 680-0. 808) . At the optimal cut-off value of6. 15 kPa, LSM had a sensitivity of 62. 4%, a specificity of 76. 3%, an accuracy of 72. 1%, a positive predictive value of 72. 5%, and a negative predictive value of 67. 0% in predicting significant liver fibrosis. Conclusion LSM has a good value in predicting significant liver fibrosis in HBeAg-positive patients with chronic HBV infection.
- hepatitis B, chronic,
- hepatitis B e antigens,
- liver cirrhosis,
- liver stiffness measurement,
- diagnosis

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[1]SCHWEITZER A, HORN J, MIKOLAJCZYK RT, et al.Estimations of worldwide prevalence of chronic hepatitis B virus infection:A systematic review of data published between 1965 and2013[J].Lancet, 2015, 386 (10003) :1546-1555.

[2]European Association for the Study of the Liver.EASL clinical practice guidelines:Management of chronic hepatitis B virus infection[J].J Hepatol, 2012, 57 (1) :167-185.

[3]TERRAULT NA, LOK ASF, McMAHON BJ, et al.Update on prevention, diagnosis, and treatment of chronic hepatitis B:AASLD 2018 hepatitis B guidance[J].Hepatology, 2018, 67 (4) :1560-1599.

[4]Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association.The guideline of prevention and treatment for chronic hepatitis B:A 2015 update[J].J Clin Hepatol, 2015, 31 (12) :1941-1960. (in Chinese) 中华医学会肝病学分会, 中华医学会感染病学分会.慢性乙型肝炎防治指南 (2015年更新版) [J].临床肝胆病杂志, 2015, 31 (12) :1941-1960.

[5]CAVIGLIA GP, ABATE ML, PELLICANO R, et al.Chronic hepatitis B therapy:Available drugs and treatment guidelines[J].Minerva Gastroenterol Dietol, 2015, 61 (2) :61-70.

[6]DENG GH, WANG ZL, WANG YM, et al.Dynamic determination and analysis of serum virus load in patients with chronic HBV infection[J].World Chin J Dig, 2004, 12 (4) :862-865. (in Chinese) 邓国宏, 王宗笠, 王宇明, 等.慢性HBV感染者血清病毒动力学的检测及分析[J].世界华人消化杂志, 2004, 12 (4) :862-865.

[7]SHARAIHA RZ, KUMTA NA, SAUMOY M, et al.Endoscopic sleeve gastroplasty significantly reduces body mass index and metabolic complications in obese patients[J].Clin Gastroenterol Hepatol, 2017, 15 (4) :504-510.

[8]OU H, CAI S, LIU Y, et al.A noninvasive diagnostic model to assess nonalcoholic hepatic steatosis in patients with chronic hepatitis B[J].Therap Adv Gastroenterol, 2017, 10 (2) :207-217.

[9]PENG J, CAI S, YU T, et al.Aspartate aminotransferase to platelet ratio index-a reliable predictor of therapeutic efficacy and improvement of Ishak score in chronic hepatitis B patients treated with nucleoside analogues[J].Scand J Clin Lab Invest, 2016, 76 (2) :133-142.

[10]BRAVO AA, SHETH SG, CHOPRA S.Liver biopsy[J].N Engl J Med, 2001, 344 (7) :495-500.

[11]BEDOSSA P, POYNARD T.An algorithm for the grading of activity in chronic hepatitis C.The METAVIR Cooperative Study Group[J].Hepatology, 1996, 24 (2) :289-293.

[12]CASTERA L, FORNS X, ALBERTI A.Non-invasive evaluation of liver fibrosis using transient elastography[J].J Hepatol, 2008, 48 (5) :835-847.

[13]European Association for Study of Liver, Asociacion Latinoamericana para el Estudio del Higado.EASL-ALEH clinical practice guidelines:Non-invasive tests for evaluation of liver disease severity and prognosis[J].J Hepatol, 2015, 63 (1) :237-264.

[14]CAO FM, ZHANG ZR, WANG X.The study correlation between liver stiffness and pathological staging of liver biopsy in patients with chronic hepatitis B by Fibroscan[J].Hebei Medicine, 2018, 24 (7) :1223-1226. (in Chinese) 曹发明, 张照如, 王翔.Fibroscan测定慢性乙型肝炎患者肝硬度值与肝组织活检病理学分期的相关性研究[J].河北医学, 2018, 24 (7) :1223-1226.

[15] DUAN WJ, WANG XM, WANG Y, et al.Comparison of FibroTouch and FibroScan for the assessment of fibrosis in chronic hepatitis B patients[J].Chin J Exp Clin Virol, 2018, 32 (4) :399-402. (in Chinese) 段维佳, 王晓明, 王宇, 等.FibroTouch和FibroScan检测评估慢性乙型肝炎患者肝纤维化程度的诊断价值[J].中华实验和临床病毒学杂志, 2018, 32 (4) :399-402.

[16]TAN YW, ZHOU XB, YE Y, et al.Diagnostic value of FIB-4, aspartate aminotransferase-to-platelet ratio index and liver stiffness measurement in hepatitis B virus-infected patients with persistently normal alanine aminotransferase[J].World JGastroenterol, 2017, 23 (31) :5746-5754.

[17]ZHANG XY, QIAN J, HOU W, et al.Clinical value of diagnosing hepatic fibrosis by Mohamadnejad model and FibroScan in the HBe Ag negative chronic hepatitis B virus carriers[J].Chin J Exp Clin Virol, 2018, 32 (1) :70-74. (in Chinese) 张孝盈, 钱静, 侯伟, 等.利用Mohamadnejad模型和FibroScan诊断HBe Ag阴性慢性HBV携带者肝纤维化的临床价值[J].中华实验和临床病毒学杂志, 2018, 32 (1) :70-74.

[18]CHAN AO, YUEN MF, LAM CM, et al.Prevalence and characteristics of familial hepatocellular carcinoma caused by chronic hepatitis B infection in Hong Kong[J].Aliment Pharmacol Ther, 2004, 19 (4) :401-406.

[19]LIN CL, KAO JH.Review article:The prevention of hepatitis B-related hepatocellular carcinoma[J].Aliment Pharmacol T-her, 2018, 48 (1) :5-14.

[20]ZHOU JL, WU XN, SUN YM, et al.Progress in clinical studies of noninvasive early diagnosis of liver fibrosis and cirrhosis[J].JClin Hepatol, 2018, 34 (8) :1674-1677. (in Chinese) 周家玲, 吴晓宁, 孙亚朦, 等.ALT水平对乙型肝炎肝硬化患者肝脏硬度值的影响[J].临床肝胆病杂志, 2018, 34 (8) :1674-1677.

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Value of liver stiffness measurement in the diagnosis of liver fibrosis degree in HBeAg-positive patients with chronic HBV infection

DOI: 10.3969/j.issn.1001-5256.2019.06.016