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EASL‐ALEH 2015 algorithm for the use of transient elastography in treatment‐naive patients with hepatitis B: An independent validation
Author(s) -
Nana Jean,
Skaare Kristina,
Bosson Jean Luc,
Leroy Vincent,
Asselah Tarik,
Adler Michael,
Sturm Nathalie,
Zarski JeanPierre
Publication year - 2021
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.13548
Subject(s) - transient elastography , medicine , algorithm , liver biopsy , elastography , biopsy , fibrosis , receiver operating characteristic , confidence interval , diagnostic accuracy , population , stage (stratigraphy) , youden's j statistic , liver fibrosis , gastroenterology , radiology , nuclear medicine , ultrasound , mathematics , paleontology , environmental health , biology
Various non‐invasive methods have been evaluated in chronic hepatitis B, but none of them have been fully validated for the assessment of liver fibrosis. The issued EASL‐ALEH 2015 guidelines provide detailed algorithms based on LSM and ALT serum levels. The aim of our study was to validate the diagnostic accuracy of this algorithm and to better understand discrepancies. Four hundred and thirteen patients from 3 centres were retrospectively included. All included patients were classified for fibrosis stage according to results of a liver biopsy. The overall diagnostic value was expressed with AUROCs given with 95% confidence intervals for the diagnostic targets. For each diagnostic target, optimal cut‐offs were determined according to the Youden method. For the population of patients with ALT9 kPa, respectively. For patients with ALT>N but ≤5N ( n = 306), AUROCs of transient elastography were 0.79 (0.73–0.84) and 0.84 (0.75–0.92) for F ≥ 2 and F ≥ 3 diagnostic targets. The prevalence of significant fibrosis was, respectively, 15%, 52% and 85% when LSM was <6kPa, between 6 and 12 kPa or >12 kPa. Our study independently validates the EASL‐ALEH algorithm based on ALT levels and LSM assessed by transient elastography.