title: Performance of Enhanced Liver Fibrosis test and comparison with transient elastography in the identification of liver fibrosis in patients with chronic hepatitis B infection.
abstract: 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.
authors.affiliation: Institute for Liver and Digestive Health, Division of Medicine, University College London, London, UK.
authors.forename: P M
authors.initials: PM
authors.lastname: Trembling
authors.forename: P
authors.initials: P
authors.lastname: Lampertico
authors.forename: J
authors.initials: J
authors.lastname: Parkes
authors.forename: S
authors.initials: S
authors.lastname: Tanwar
authors.forename: M
authors.initials: M
authors.lastname: Viganò
authors.forename: F
authors.initials: F
authors.lastname: Facchetti
authors.forename: M
authors.initials: M
authors.lastname: Colombo
authors.forename: W M
authors.initials: WM
authors.lastname: Rosenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D001706:Biopsy; D019411:Clinical Laboratory Techniques / Q000379:methods*; D015331:Cohort Studies; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D006651:Histocytochemistry; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: Enhanced Liver Fibrosis test; chronic hepatitis B; liver fibrosis; noninvasive markers; transient elastography
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