Comparison of liver stiffness, fibrotest and liver biopsy for assessment of liver fibrosis in kidney-transplant patients with chronic viral hepatitis.
To assess the accuracy of the noninvasive tools, fibrotest (FT) and liver stiffness measurement (LSM) for assessing liver fibrosis in kidney-transplant patients with chronic hepatitis virus B (HBV) or C (HCV) infection. Thirty-eight consecutive kidney-transplant patients with HCV (n = 26) or HBV (n = 12) underwent liver biopsies followed by a FT and LSM. Liver biopsies gave the following fibrosis-grade distribution using METAVIR scores: F0/F1, n = 10 (26.9%); F2, n = 14 (36.8%), F3, n = 7 (18.42%); F4, n = 7 (18.4%). The area under the receiver-operating characteristic curve for mild fibrosis stage <F2 was 0.69 (0.47-0.91) for the FT and 0.68 (0.45-0.90) for LSM; for severe fibrosis stage F3-F4, they were 0.55 (0.35-0.76) for the FT and 0.69 (0.50-0.87) for LSM. Eighty to 90% of patients with no significant liver fibrosis (<F2) were well-classified, with a cut-off value <0.5 for the FT and <7.1 kPa for LSM. Diagnosis of patients with severe liver fibrosis (F3/F4) by FT and LSM differed by 38.4% from the liver biopsy data. The FT and LSM are acceptably accurate for diagnosing mild liver fibrosis in kidney-transplant patients with chronic HCV or HBV infections, but their diagnostic value for predicting severe liver disease needs to be confirmed.
Alric
Laurent
L
Service de Médecine Interne, Fédération Digestive, CHU Purpan, Toulouse, France. alric.l@chu-toulouse.fr
Kamar
Nassim
N
Bonnet
Delphine
D
Danjoux
Marie
M
Abravanel
Florence
F
Lauwers-Cances
Valérie
V
Rostaing
Lionel
L
D000328:Adult; D001706:Biopsy; D004548:Elasticity; D005260:Female; D019694:Hepatitis B, Chronic / Q000473:pathology*; D019698:Hepatitis C, Chronic / Q000473:pathology*; D006801:Humans; D016030:Kidney Transplantation; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies