4.5 Article

Assessment of liver fibrosis by transient elastography and multi-parameters model in young children with chronic hepatitis B virus infection

Journal

BMC INFECTIOUS DISEASES
Volume 22, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s12879-022-07142-7

Keywords

Chronic hepatitis B; Liver fibrosis; Diagnosis; Transient elastography; Multi-parameter indicators; Children

Funding

  1. Hunan Provincial Development and Reform Commission in China [[2019] 875]

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This study compared the diagnostic value of transient elastography (TE) and multivariate indicators with liver biopsy for the detection of liver fibrosis in children with chronic hepatitis B (CHB). The results showed that TE had better diagnostic value for significant liver fibrosis compared to APRI and FIB-4.
Objective This study aimed to compare the diagnostic value of the single or combined applications of transient elastography (TE) and multivariate indicators with biopsy for the detection of liver fibrosis in children caused by chronic hepatitis B (CHB). Methods This study included 148 CHB children treated at Hunan Children's Hospital from January 1st 2015 to December 31st 2018, aged from 0.83 to 14.58 years old. All patients underwent liver biopsy (LB), of which 43 patients underwent TE. Multiple clinical data, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), Platelet (PLT), and HBV-deoxyribonucleic acid (HBV DNA) of all patients were collected. The diagnostic values for CHB of TE and its combinations with these indicators were measured. The patients were classified in two ways: no hepatic fibrosis group (F0) versus fibrosis group (F >= 1), and no significant hepatic fibrosis group (F < 2) versus significant hepatic fibrosis group (F >= 2). The statistical assessment was performed between groups within each classification to compare the diagnostic value of different parameters. Results The operating characteristic area under curve (AUC) of liver fibrosis diagnosed by liver stiffness measurement (LSM) which obtained by TE, AST-to-PLT ratio index (APRI), and fibrosis-4 index (FIB-4) were 0.740, 0.701, and 0.651, while the corresponding cut-off values were 5.9 kPa, 0.50, and 0.10, respectively. The AUC of significant liver fibrosis diagnosed by LSM, APRI and FIB-4 were 0.849, 0.701, and 0.509, while the corresponding cut-off values were 8.4 kPa, 0.76, and 0.08, respectively. While with the combinations of LSM and APRI, LSM and FIB-4, LSM and APRI and FIB-4, APRI and FIB-4, the AUC of significant liver fibrosis were 0.866, 0.855, 0.869, and 0.684, respectively. The AUC of significant liver fibrosis diagnosed by the LSM was significantly higher than APRI and FIB-4. Conclusions The diagnostic value of transient elastography was better than that of APRI and FIB-4 for CHB children with significant liver fibrosis. In addition, TE also has relatively high application values on the diagnosis of patients with different degrees of liver fibrosis caused by CHB.

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