title: Performance and Utility of Transient Elastography and Non-Invasive Markers of Liver Fiibrosis in Patients with Autoimmune Hepatitis: A Single Centre Experience.
abstract: OBJECTIVE
  Autoimmune hepatitis (AIH) is a relatively rare cause of hepatic dysfunction, which can lead to acute liver failure (ALV) and cirrhosis if not treated. The performance of transient elastography (TE) compared to liver biopsy has been evaluated in many liver diseases. The aim of the present study was to evaluate the performance of TE and other non-invasive markers for liver fiibrosis in patients with biopsy-proven AIH.
  
  
  METHODS
  Fifty-three patients who were treated at the department of gastroenterology and hepatology of the University Clinic Essen from 2008 to 2013 included in this retrospective study. Laboratory parameters were used to calculate non-invasive markers for liver fiibrosis. Every patient underwent a liver biopsy within 6 months of the liver stiffness measurement.
  
  
  RESULTS
  Transient elastography score, non-alcoholic fatty liver disease (NAFLD) fiibrosis score, Fiibrosis 4 score (FIB-4), and FibroQ were associated with the stage of fiibrosis, whereas other non-invasive markers of liver fiibrosis (aspartate transaminase (AST) to alanine transaminase (ALT) ratio, and AST to platelet ratio index (APRI)) did not demonstrate a significant correlation. NAFLD fiibrosis score and FibroQ performed slightly better in ROC curve analysis than TE in differentiating mild to moderate from severe fiibrosis (AUC 0.895 and 0.773 vs. 0.739; P < 0.001 and = 0.01, respectively), while TE performed slightly better, but still not adequate, in differentiating mild from all other stages of fiibrosis compared to NAFLD fiibrosis score and FibroQ (AUC 0.779 vs. 0.752 and 0.684; P = 0.051 and 0.009).
  
  
  CONCLUSIONS
  Transient elastography, NAFLD fiibrosis score, and FibroQ are valuable non-invasive markers for the evaluation of liver fiibrosis in autoimmune hepatitis but they cannot replace liver biopsy, especially in differentiating mild from more advanced stages of fiibrosis.
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital, University Duisburg Essen, Germany.
authors.forename: Olympia
authors.initials: O
authors.lastname: E Anastasiou
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital, University Duisburg Essen, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Büchter
authors.affiliation: Department of Pathology, University Hospital, University Duisburg Essen, Germany.
authors.forename: Hideo
authors.initials: H
authors.lastname: A Baba
authors.affiliation: Department of Nephrology, University Hospital, University Duisburg Essen, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Korth
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital, University Duisburg Essen, Germany.
authors.forename: Ali
authors.initials: A
authors.lastname: Canbay
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital, University Duisburg Essen, Germany.
authors.forename: Guido
authors.initials: G
authors.lastname: Gerken
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital, University Duisburg Essen, Germany.
authors.forename: Alisan
authors.initials: A
authors.lastname: Kahraman
keywords: APRI; Autoimmune Hepatitis; FibroQ; NAFLD Fiibrosis Score; Transient Elastography