Open AccessNon-invasive assessment of liver fibrosis in chronic hepatitis B
Author(s) -
Federica Branchi,
Clara Benedetta Conti,
Alessandra Baccarin,
Pietro Lampertico,
Dario Conte,
Mirella Fraquelli
Publication year - 2014
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v20.i40.14568
Subject(s) - transient elastography , medicine , hepatocellular carcinoma , cirrhosis , portal hypertension , liver biopsy , fibrosis , esophageal varices , elastography , hepatitis b virus , hepatic fibrosis , decompensation , hepatitis b , gastroenterology , biopsy , pathology , radiology , liver fibrosis , immunology , virus , ultrasound
The goal of this review is to provide a comprehensive picture of the role, clinical applications and future perspectives of the most widely used non-invasive techniques for the evaluation of hepatitis B virus (HBV) infection. During the past decade many non-invasive methods have been developed to reduce the need for liver biopsy in staging fibrosis and to overcome whenever possible its limitations, mainly: invasiveness, costs, low reproducibility, poor acceptance by patients. Elastographic techniques conceived to assess liver stiffness, in particular transient elastography, and the most commonly used biological markers will be assessed against their respective role and limitations in staging hepatic fibrosis. Recent evidence highlights that both liver stiffness and some bio-chemical markers correlate with survival and major clinical end-points such as liver decompensation, development of hepatocellular carcinoma and portal hypertension. Thus the non-invasive techniques here discussed can play a major role in the management of patients with chronic HBV-related hepatitis. Given their prognostic value, transient elastography and some bio-chemical markers can be used to better categorize patients with advanced fibrosis and cirrhosis and assign them to different classes of risk for clinically relevant outcomes. Very recent data indicates that the combined measurements of liver and spleen stiffness enable the reliable prediction of portal hypertension and esophageal varices development.