Non-invasive assessment of liver fibrosis in chronic hepatitis B

Table 1 Transient elastography performance for the diagnosis of significant fibrosis (F ≥ 2) in chronic hepatitis B

Ref.	Patients (n)	Cut-off (kPa)	Sn	Sp	LR-	LR+	AUROC (95%CI)
Oliveri et al[21]	188	7.5	93%	88%	0.07	8.2	0.96 (0.94-0.99)
Marcellin et al[89]	173	7.2	70%	83%	0.36	2.6	0.81 (0.73-0.86)
Chan et al[34]	161	8.4	84%	76%	0.20	3.5	0.87 (0.82-0.93)
Degos et al[90]	284	5.2	89%	38%	0.28	1.4	-
Viganò et al[25]	217	8.7	64%	92%	0.40	7.5	-
Verveer et al[27]	241	6.0	-	-	-	-	0.85
Cardoso et al[26]	202	7.2	74%	88%	0.30	6.2	0.86

Sn: Sensitivity; Sp: Specificity; LR^-: Negative likelihood ratio; LR⁺: Positive likelihood ratio; AUROC: Area under receiver operating characteristic.

Table 2 Transient elastography performance for the diagnosis of cirrhosis (F4) in chronic hepatitis B

Ref.	Patients (n)	Cut-off (kPa)	Sn	Sp	LR-	LR+	AUROC (95%CI)
Oliveri et al[21]	188	11.8	93%	88%	0.07	8.2	0.97 (0.95-0.99)
Marcellin et al[89]	173	11.0	70%	83%	0.36	7.1	0.93 (0.82-0.98)
Chan et al[34]	161	13.4	79%	92%	0.20	9.8	0.93 (0.89-0.97)
Viganò et al[25]	217	9.4	100%	82%	0.01	5.5	-
Cardoso et al[26]	202	11.0	75%	90%	0.20	7.3	0.93

Sn: Sensitivity; Sp: Specificity; LR^-: Negative likelihood ratio; LR⁺: Positive likelihood ratio; AUROC: Area under receiver operating characteristic.

Table 3 Transient elastography performance for the detection of portal hypertension and esophageal varices in various settings including chronic hepatitis B

Ref.	Prevalence	Aetiology	Patients (n)	Cut off (kPa)	Sn	Sp	LR-	LR+	AUROC
	Significant PH1
Bureau et al[91]	51%	Mixed	150	21.0	90%	93%	0.10	12.8	0.94 (0.90-0.98)
Robic et al[38]	51%	Mixed	100	21.1	100%	65%	0.00	2.8	0.84 (0.76-0.82)
	EV
Kazemi et al[40]	41%	Mixed	165	13.919	95% 91%	43% 60%	0.13 0.14	1.7 2.3	0.83 (0.78-0.90)0.84 (0.76-0.89)
Bureau et al[91]	72%48%2	Mixed	150	21.1 29.3	84% 81%	71% 61%	0.22 0.31	2.9 2.1	0.85 (0.77-0.82)0.76 (0.67-0.85)
Nguyen-Khac et al[92]	22%	Mixed	183	48	73%	73%	0.37	2.7	0.76 (0.69-0.82)
Kim et al[42]	32%2	HBV	280	5.53	94%	94%	0.06	15.7	0.95 (0.93-0.97)
Sporea et al[39]	35%2	Mixed	1000	31	83%	62%	0.27	2.2	0.78
Chen et al[41]	80%2	HBV	222	17.1	90%	44%	0.22	1.6	0.73 (0.66-0.80)
Wang et al[93]	38%10%2	HBV	126	1221	67% 77%	77% 87%	0.43 0.27	2.89 5.79	0.73 (0.65-0.80)0.86 (0.79-0.91)

¹Hepatic vein pressure gradient > 12 mmHg;

²Large/high risk esophageal varices;

³LSPS. Sn: Sensitivity; Sp: Specificity; LR^-: Negative likelihood ratio; LR⁺: Positive likelihood ratio; AUROC: Area under receiver operating characteristic; HBV: Hepatitis B virus.

Table 4 Major biochemical markers evaluated in chronic hepatitis B setting

Serum panel	Parameters
Fibrotest	Haptoglobin, a2macroglobulin, apolipoprotein-A1, gGT, total bilirubin, gammaglobulin
APRI	AST, platelets
FIB-4	Age, AST, ALT, platelets
Forn’s	Age, platelets, gGT, cholesterol
GUCI	AST, INR, platelets
Hui’s	Body mass index, platelets, albumin and bilirubin

gGT: Gammaglutamyltranspeptidase; AST: Aspartate aminotransferase; ALT: Alanine aminotransferaese; INR: Intrnational normalised ratio; APRI: AST to platelet ratio index; FIB-4: Fibrosis score 4.

Table 5 Performances of Fibrotest for the diagnosis of fibrosis (F2-F4) and assessment of prognosis in chronic hepatitis B

Outcome	Patients (n)	Cut-off (kPa)	Sn	Sp	LR+	LR-	AUROC (95%CI)	Ref
Significant fibrosis F ≥ 2	194	0.32	79.3%	93.3%	11.8	0.2	0.90 (0.84-0.97)	[74]
	254	0.48	54.2%	83.3%	3.3	0.6	0.69 (0.63-0.75)	[72]
Cirrhosis F4	194	0.68	80.0%	84.0%	5	0.2	0.87 (0.82-0.92)	[74]
	254	0.75	42.1%	91.4%	4.9	0.6	0.68 (0.63-0.73)	[72]
Prediction of 5-yr survival	600	≤ 0.73> 0.85	-	-	-	-	0.82 (0.71-0.89)	[51]

Sn: Sensitivity; Sp: Specificity; LR^-: Negative likelihood ratio; LR⁺: Positive likelihood ratio; AUROC: Area under receiver operating characteristic.