title: FibroSURE as a noninvasive marker of liver fibrosis and inflammation in chronic hepatitis B.
abstract: BACKGROUND
  Noninvasive markers of liver fibrosis have not been extensively studied in patients with chronic hepatitis B virus (HBV) infection. Our aim was to evaluate the capacity of FibroSURE, one of the two noninvasive fibrosis indices commercially available in the United States, to identify HBV infected patients with moderate to severe fibrosis.
  
  
  METHODS
  Forty-five patients who underwent liver biopsy at a single tertiary care center were prospectively enrolled and had FibroSURE performed within an average interval of 11 days of the biopsy.
  
  
  RESULTS
  Of the 45 patients, 40% were Asian, 40% were African American, and 13% were Caucasian; 27% were co-infected with HIV and 67% had no or mild fibrosis. We found FibroSURE to have moderate capacity to discriminate between patients with moderate to high fibrosis and those with no to mild fibrosis (area under receiver operating characteristic [AUROC] curve = 0.77; 95% confidence interval [CI] [0.61, 0.92]). When we combined the fibrosis score determined by FibroSURE with aspartate aminotransferase (AST) measurements and HIV co-infection status, the discriminatory ability significantly improved reaching an AUROC of 0.90 (95% CI [0.80, 1.00]). FibroSURE also had a good ability to differentiate patients with no or mild from those with moderate to high inflammation (AUROC = 0.83; 95% CI [0.71, 0.95]).
  
  
  CONCLUSIONS
  FibroSURE in combination with AST levels has an excellent capacity to identify moderate to high fibrosis stages in chronic HBV-infected patients. These data suggest that FibroSURE may be a useful substitute for liver biopsy in chronic HBV infection.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medical College, New York, NY, USA. maz2003@med.cornell.edu.
authors.forename: Marija
authors.initials: M
authors.lastname: Zeremski
authors.forename: Rositsa B
authors.initials: RB
authors.lastname: Dimova
authors.forename: Samantha
authors.initials: S
authors.lastname: Benjamin
authors.forename: Jessy
authors.initials: J
authors.lastname: Makeyeva
authors.forename: Rhonda K
authors.initials: RK
authors.lastname: Yantiss
authors.forename: Maya
authors.initials: M
authors.lastname: Gambarin-Gelwan
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Talal
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism; D016632:Apolipoprotein A-I / Q000378:metabolism; D019540:Area Under Curve; D001219:Aspartate Aminotransferases / Q000378:metabolism; D001663:Bilirubin / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D001706:Biopsy; D015331:Cohort Studies; D005260:Female; D006242:Haptoglobins / Q000378:metabolism; D019694:Hepatitis B, Chronic / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000473:pathology*; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index; D000511:alpha-Macroglobulins / Q000378:metabolism; D005723:gamma-Glutamyltransferase / Q000378:metabolism
chemical_list: D016632:Apolipoprotein A-I; D015415:Biomarkers; D006242:Haptoglobins; D000511:alpha-Macroglobulins; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin