Is liver biopsy still needed in children with chronic viral hepatitis?

Table 4 Diagnostic performance of the main non-invasive methods used to determine significant liver fibrosis (METAVIR F ≥ 2) and cirrhosis (METAVIR F4) in adult and pediatric patients

Test	Patients (n)	Disease	AUROC		Ref.
			F≥2	F4
Fibrotest	3501	HCV	0.85	-	Poynard et al[82]
Fibrotest	1457	HBV	0.80	-	Poynard et al[82]
Fibrotest	1161	Chronic liver disease	-	0.73	de Lédinghen et al[69]
APRI	6259	HCV	0.77	0.83	Lin et al[83]
APRI	1161	Chronic liver disease	-	0.73	de Lédinghen et al[69]
TE	251	HCV	0.79	0.97	Ziol et al[84]
TE	183	HCV	0.83	0.95	Castéra et al[47]
TE	165	HCV	0.88	0.90	Nitta et al[85]
TE	400	HCV	0.818	0.932	Sporea et al[86]
TE	173	HBV	0.81	0.93	Marcellin et al[87]
TE	175	HBV	0.95	0.98	Zhu et al[88]
TE	1161	Chronic liver disease	-	0.88	de Lédinghen et al[69]
TE	301	HCV	0.815	1.00	Awad et al[89]
ARFI	911	HCV	0.792	0.842	Sporea et al[86]

¹Children. AUROC: Area under the receiver operator characteristic curve; APRI: Aspartate-to-platelet ratio index; ARFI: Acoustic Radiation Force Impulse Imaging; TE: Transient elastography; HCV: Hepatitis C virus.