BACKGROUND: Liver stiffness measurement (LSM) by transient elastography is a popular noninvasive test of fibrosis. Traditional LSM cutoffs dichotomize patients and do not clearly indicate the confidence of diagnosis. AIM: We derived and validated probability functions of fibrosis and cirrhosis based on LSM and determined the effect of alanine aminotransferase (ALT) on the scores. METHODS: Consecutive chronic hepatitis B patients who underwent liver function tests, LSM, and liver biopsies at six European and Asian centers (2/3 in the training cohort and 1/3 in the validation cohort) were recruited. Binary logistic regression was performed to predict the probabilities of different fibrosis stages based on LSM and/or ALT. RESULTS: A total of 1,051 patients were included in the final analysis (53 % with ALT ≥ 60 IU/L, 32 % F2, 20 % F3, and 24 % F4). The probability functions (LiFA-HBV score) with and without ALT adjustment closely mirrored the proportion with different fibrosis stages in both the training and validation cohorts. For a range of up to 300 IU/L, ALT maintained a weak linear relationship with LSM for each fibrosis stage (r (2) = 0.018-0.13). Based on relative integrated discrimination improvement, the addition of ALT to the LiFA-HBV score increased the correct reclassification of F3-4 and F4 by 5 and 17 %, respectively. CONCLUSIONS: ALT increases LSM in a linear fashion in chronic hepatitis B patients at any fibrosis stage. The LiFA-HBV score accurately predicts the probability of fibrosis. ALT adjustment increases the rate of reclassification modestly and is not essential.
BACKGROUND:Liver stiffness measurement (LSM) by transient elastography is a popular noninvasive test of fibrosis. Traditional LSM cutoffs dichotomize patients and do not clearly indicate the confidence of diagnosis. AIM: We derived and validated probability functions of fibrosis and cirrhosis based on LSM and determined the effect of alanine aminotransferase (ALT) on the scores. METHODS: Consecutive chronic hepatitis Bpatients who underwent liver function tests, LSM, and liver biopsies at six European and Asian centers (2/3 in the training cohort and 1/3 in the validation cohort) were recruited. Binary logistic regression was performed to predict the probabilities of different fibrosis stages based on LSM and/or ALT. RESULTS: A total of 1,051 patients were included in the final analysis (53 % with ALT ≥ 60 IU/L, 32 % F2, 20 % F3, and 24 % F4). The probability functions (LiFA-HBV score) with and without ALT adjustment closely mirrored the proportion with different fibrosis stages in both the training and validation cohorts. For a range of up to 300 IU/L, ALT maintained a weak linear relationship with LSM for each fibrosis stage (r (2) = 0.018-0.13). Based on relative integrated discrimination improvement, the addition of ALT to the LiFA-HBV score increased the correct reclassification of F3-4 and F4 by 5 and 17 %, respectively. CONCLUSIONS: ALT increases LSM in a linear fashion in chronic hepatitis Bpatients at any fibrosis stage. The LiFA-HBV score accurately predicts the probability of fibrosis. ALT adjustment increases the rate of reclassification modestly and is not essential.
Authors: Jorg Petersen; Vlad Ratziu; Maria Buti; Harry L A Janssen; Ashley Brown; Pietro Lampertico; Jan Schollmeyer; Fabien Zoulim; Heiner Wedemeyer; Martina Sterneck; Thomas Berg; Christoph Sarrazin; Marc Lutgehetmann; Peter Buggisch Journal: J Hepatol Date: 2011-10-26 Impact factor: 25.083
Authors: Patrick Marcellin; Edward Gane; Maria Buti; Nezam Afdhal; William Sievert; Ira M Jacobson; Mary Kay Washington; George Germanidis; John F Flaherty; Raul Aguilar Schall; Jeffrey D Bornstein; Kathryn M Kitrinos; G Mani Subramanian; John G McHutchison; E Jenny Heathcote Journal: Lancet Date: 2012-12-10 Impact factor: 79.321
Authors: Kyu Sik Jung; Seung Up Kim; Sang Hoon Ahn; Young Nyun Park; Do Young Kim; Jun Yong Park; Chae Yoon Chon; Eun Hee Choi; Kwang-Hyub Han Journal: Hepatology Date: 2011-02-11 Impact factor: 17.425
Authors: H L-Y Chan; G L-H Wong; P C-L Choi; A W-H Chan; A M-L Chim; K K-L Yiu; F K-L Chan; J J-Y Sung; V W-S Wong Journal: J Viral Hepat Date: 2008-07-28 Impact factor: 3.728
Authors: Pik Eu Chang; Juanda Leo Hartono; Yee Lin Ngai; Yock Young Dan; Kieron Bl Lim; Wan Cheng Chow Journal: Singapore Med J Date: 2018-12-17 Impact factor: 1.858
Authors: Ja Yoon Heo; Beom Kyung Kim; Jun Yong Park; Do Young Kim; Sang Hoon Ahn; Hyon-Suk Kim; Young Nyun Park; Kwang-Hyub Han; Kijun Song; Seung Up Kim Journal: Gut Liver Date: 2018-03-15 Impact factor: 4.519