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Performance of Enhanced Liver Fibrosis test and comparison with transient elastography in the identification of liver fibrosis in patients with chronic hepatitis B infection
Author(s) -
Trembling P. M.,
Lampertico P.,
Parkes J.,
Tanwar S.,
Viganò M.,
Facchetti F.,
Colombo M.,
Rosenberg W. M.
Publication year - 2014
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.12161
Subject(s) - transient elastography , medicine , cirrhosis , fibrosis , liver biopsy , gastroenterology , liver fibrosis , chronic liver disease , liver disease , biopsy , hepatic fibrosis , stage (stratigraphy) , pathology , biology , paleontology
Summary Assessment of liver fibrosis is important in determining prognosis, disease progression and need for treatment in patients with chronic hepatitis B ( CHB ). Limitations to the use of liver biopsy in assessing fibrosis are well recognized, and noninvasive tests are being increasingly evaluated including transient elastography ( TE ) and serum markers such as the Enhanced Liver Fibrosis ( ELF ) test. We assessed performance of ELF and TE in detecting liver fibrosis with reference to liver histology in a cohort of patients with CHB ( n = 182), and compared the performance of these modalities. Median age was 46 and mean AST 70 IU/L. Cirrhosis was reported in 20% of liver biopsies. Both modalities performed well in assessing fibrosis at all stages. Area under receiver operator characteristic ( AUROC ) curves for detecting METAVIR fibrosis stages F ≥ 1, F ≥ 2, F ≥ 3 and F4 were 0.77, 0.82, 0.80 and 0.83 for ELF and 0.86, 0.86, 0.90 and 0.95 for TE . TE performed significantly better in the assessment of severe fibrosis ( AUROC 0.80 for ELF and 0.90 for TE , P < 0.01) and cirrhosis (0.83 for ELF and 0.95 for TE , P < 0.01). This study demonstrates that ELF has good performance in detection of liver fibrosis in patients with CHB , and when compared, TE performs better in detection of severe fibrosis/cirrhosis.