scholarly journals Assessment of liver fibrosis in children with chronic HBV infection by non!invasive methods

2021 ◽  
pp. 19-24
Author(s):  
V.S. Berezenko ◽  
◽  
O.M. Tkalik ◽  
M.B. Dyba ◽  
V.V. Krat ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Shear Wave ◽  
Shear Wave Elastography ◽  
Hbv Infection ◽  
Fibrosis Stage ◽  
Chronic Hbv Infection ◽  
Positive Chronic Hepatitis ◽  
Apri Score ◽  
Chronic Hbv

Purpose — to assess liver fibrosis in children with chronic HBV infection with nonEinvasive methods: instrumental (shear wave elastography) and serological (APRI score). Materials and methods. 70 children with HCV aged 2–17 years were examined. The stage of liver fibrosis was determined by the APRI index and the method of shear wave elastography. Results. The majority (82.8%; n=58) of children were diagnosed with HBeAgEpositive HBV infection: HBeAg-positive chronic hepatitis occurred in 54.3% (n=38) of children, HBeAg-positive chronic infection in 28.6% (n=20). 15.7% (n=11) of children had HBeAg-negative chronic infection, and only one (1.4%) patient had HBeAg-negative chronic hepatitis. According to the results of shear wave elastography, in 64.3% (n=45) the stage of liver fibrosis F0-1 was diagnosed; in 35.7% (n=25) — stage of fibrosis >F2. According to APRI score, 63.0% (n=44) had liver fibrosis F0-1, and liver fibrosis stage >F2 was diagnosed in 37.2% (n=26). According to liver elastography, 42.0% of patients with HBeAg-positive chronic hepatitis were diagnosed with liver fibrosis stage >F2. According to APRI score, almost 66% (n=46) of children with HBeAg-positive chronic hepatitis had progressive liver fibrosis >F2. According to the correlation analysis results, a direct correlation was found between liver enzymes levels and APRI score — ALT (τ=0.67; p<0.05), AST (τ=0.72; p<0.05) and GGT (τ=0.26; p<0.05). Conclusions. Most children with chronic HBV infection had stage F0-1 liver fibrosis according to both elastography and APRI score (64% and 63%, respectively). Elastography fibrosis stage >F2 was diagnosed in 42% of HBeAg-positive chronic hepatitis, while APRI index fibrosis stage >F2 was diagnosed in 66% of patients with HBeAg-positive chronic hepatitis. Thus, the results of the liver fibrosis evaluation according to the liver elastography and APRI score in children with chronic HBV infection are similar and can be used in clinical practice to select patients who require antiviral therapy. The APRI score depends on the activity of hepatitis and its use in children with HBeAg-positive chronic hepatitis has certain limitations. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: children, chronic HBV infection, fibrosis, shear wave elastography, APRI.

scholarly journals Receiver Operator Characteristics (ROC) Analysis of Real-Time Shear Wave Elastography Information Health Monitoring in Liver Fibrosis with Chronic Hepatitis B Virus Infection

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Zhexia Zhao ◽  
Xiaoyan Chen ◽  
Yanxia Zhang ◽  
Qian Song ◽  
Jiping Xue ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Elastic Modulus ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Shear Wave Elastography ◽  
Hbv Infection ◽  
Chronic Hbv Infection ◽  
Chronic Hbv ◽  
The Right

To investigate the effectiveness of shear-wave elastography (SWE) based on e-health in diagnosing liver fibrosis in patients infected with hepatitis B virus (HBV) and provide theoretical basis for early diagnosis and treatment of patients with chronic HBV infection, in this study, 73 patients with chronic HBV infection who underwent e-health SWE examination were divided into chronic hepatitis B group (51 cases) and hepatitis B cirrhosis group (22 cases), and another 20 healthy volunteers were introduced as control. The contents of second liver two half-and-half, hyaluronic acid (HA) of liver fibrosis, laminin (LN), pAUVollagen III N terminal peptide (PIII NP), collage type IV (CIV), and HBV-DNA were detected. SWE was used to measure the elastic modulus in the S2 and S3 segments of the left outer lobe of the liver, S4 segment of the left inner lobe of the liver, S5 and S8 segments of the right anterior lobe of the liver, and S6 and S7 segments of the right posterior lobe of the liver. Finally, the correlations between the four examination results of liver fibrosis and the elastic modulus values were compared, and the receiver operator characteristic curve (ROC) for SWE technical diagnosis was drawn. The results showed that there was no significant difference in HBV-DNA content between the two groups ( P > 0.05 ); the contents of alanine transaminase (ALT) and aspartate aminotransferase (AST) in the blood of chronic hepatitis B group were significantly higher than those in the liver cirrhosis group ( P < 0.05 ); HA, PIII NP, and CIV contents were significantly lower than the liver cirrhosis group ( P < 0.05 ); the success rates of SWE detection in S5 and S6 segments of the two groups were 100.00%, and the elastic modulus of the hepatitis B cirrhosis group was significantly higher than that of the chronic hepatitis B group ( P < 0.05 ); correlation results showed HA, PIII NP, and CIV of two groups of patients and elastic modulus value in S5 and S6 segments showed positive correlation ( P < 0.05 ); ROC curve analysis showed that AUC (area under the curve) was 0.866, the sensitivity was 89.59%, and the specificity was 76.49%, which indicated that the liver elastic modulus value measured by e-health SWE technology can quantitatively show liver fibrosis in patients with chronic HBV infection, and its application in the diagnosis of clinical liver fibrosis was real and feasible.

scholarly journals Diagnostic Performance of Two-dimensional Shear Wave Elastography in Advanced Liver Fibrosis: A Prospective Pathology-based Study

2020 ◽  
Author(s):  
Yao-Kuang Huang ◽  
Ren-Ching Wang ◽  
Sheng-Shun Yang ◽  
Shou-Wu Lee ◽  
Hsin-Ju Tsai ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Shear Wave ◽  
Liver Diseases ◽  
Diagnostic Performance ◽  
Shear Wave Elastography ◽  
Two Dimensional ◽  
Liver Disorders ◽  
Advanced Liver Fibrosis ◽  
Invasive Method

Abstract Studies for evaluating the diagnostic performance of two-dimensional Shear-wave Elastography (2D-SWE) in a patient cohort including various liver disorders, remain limited. We aimed to evaluate the validity of 2D-SWE in the diagnosis of advanced liver fibrosis amongst patients with various liver disorders. In this pathology-based study, patients who underwent a liver biopsy for various benign liver diseases were prospectively recruited during the period between February, 2017 and September, 2020. Data of 2D-SWE, Fibrosis-4 Index (FIB-4), and Aspartate Aminotransferase to Platelet Ratio Index (APRI) were simultaneously collected. The cut-off values for predicting advanced fibrosis, i.e. Metavir fibrosis stage ≥ F3, were determined using Receiver Operating Characteristic (ROC) analysis. The diagnostic performance was evaluated and then compared by Area Under the ROC (AUROC). In total, 95 patients were recruited for study analysis. The diagnostic performance of 2D-SWE was significantly superior to that of both FIB-4 (AUROC: 0.88, 95% confidence interval [CI]: 0.80-0.94; vs 0.72, 95%CI: 0.62-0.81; p=0.001) and APRI (AUROC: 0.88, 95%CI: 80-0.94; vs 0.76, 95%CI: 0.66-0.84; p=0.007). With an optimal cutoff value of 9.3 kPa, the sensitivity and specificity were 90.91% and 76.47%, respectively. In subgroup analysis, the AUROC of 2D-SWE was the highest when compared to that of FIB-4 and APRI in patients with chronic hepatitis B, chronic hepatitis C, fatty liver, and concurrent hepatitis. 2D-SWE can therefore be a valid non-invasive method in the detection of advanced liver fibrosis in various liver diseases.

scholarly journals Burden and impacts of chronic hepatitis B infection in rural Senegal: study protocol of a cross-sectional survey in the area of Niakhar (AmBASS ANRS 12356)

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e030211 ◽  
Author(s):  
Marion Coste ◽  
Maëlle De Sèze ◽  
Aldiouma Diallo ◽  
Maria Patrizia Carrieri ◽  
Fabienne Marcellin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Hepatitis ◽  
Population Level ◽  
Clinic Visit ◽  
Hbv Infection ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Chronic Hbv Infection ◽  
Home Based ◽  
Chronic Hbv

IntroductionThough Senegal has one of the highest estimated prevalence rates of chronic hepatitis B virus (HBV) infection worldwide, epidemiological data in the general population are lacking and consequences of the infection remain undocumented. The ANRS-12356 AmBASS study aims at evaluating the health and socioeconomic burden of chronic HBV infection at the individual, household and population level. Its specific objectives are (1) to document the epidemiology of chronic HBV infection, including prevalence and risk factors; (2) to assess the acceptability of home-based testing and first clinic visit; (3) to investigate the repercussions of chronic HBV infection on living conditions; and (4) to estimate the public health impact of chronic HBV infection at the population level and the feasibility of a decentralised model of HBV test and treat.Methods and analysisThis multidisciplinary cross-sectional survey includes a twofold data collection: (1) home-based screening using dried blood spot (DBS) sampling and collection of sociodemographic, economic and behavioural data, and (2) additional clinical and biological data collection in chronic HBV carriers at the first clinic visit. The prevalence of chronic HBV infection will be estimated in the general population and in key subgroups. Risk factors for HBV acquisition in children will be explored using case-control analysis. HBV burden will be assessed through comparisons of health and economic outcomes between households affected by the disease versus non-affected households. Last, an economic evaluation will assess costs and health benefits of scaling-up HBV care.Ethics and disseminationThis study was approved by the Senegalese National Ethical Committee for Research in Health, and received authorisation from the Senegalese Ministry of Health and the French Commission on Information Technology and Liberties (Senegalese Protocol Number: SEN17/15). The study results will be presented in peer-review journals, international conferences and at a workshop with national stakeholders in order to contribute to the design of programmes to address the HBV pandemic.Trial registration numberNCT03215732; Pre-results.

A study of spleen shear-wave elastography in indirect prediction of liver fibrosis in patients with chronic hepatitis B

2020 ◽  
Vol 76 (1) ◽  
pp. 63-72
Author(s):  
Yi Zheng ◽  
Shujun Xia ◽  
Xinping Ren ◽  
Weiwei Zhan ◽  
Zhan Zheng ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Shear Wave ◽  
Chronic Hepatitis B ◽  
Characteristic Curve ◽  
Shear Wave Elastography ◽  
Final Diagnosis ◽  
Predicting Performance ◽  
Reference Index

PURPOSE: To evaluate the value of spleen shear-wave elastography (sound touch elastography [STE], sound touch quantification [STQ]) in indirect prediction of liver fibrosis in patients with chronic hepatitis B (CHB). METHODS: The Young’s modulus (kPa) of spleen STE, STQ and liver FibroScan were measured in 112 patients with CHB. The final diagnosis was according to histological results from liver biopsy based on Scheure G/S scoring system and liver FibroScan was considered as a reference index of prediction efficiency. Grouped by the stage of liver fibrosis, data were analyzed by Spearman correlation analysis, Mann-Whitney test and receiver operating characteristic curve (ROC). RESULTS: Spleen STE was positively correlated with the degree of liver fibrosis, but spleen STQ was not. STEmean and STEmax of spleen were statistically different between the groups categorized by S = 2, S = 3 and S = 4 (all p < 0.05), respectively. Spleen STEmean had the best predicting performance on staging liver fibrosis. The areas under the ROC (AUC) for spleen STEmean were 0.66 (95% confidence interval [CI], 0.56–0.76) for stage S = 2 or higher, 0.72 (95% CI, 0.60–0.83) for S = 3 or higher, 0.83 (95% CI, 0.74–0.92) for S = 4 (all P < 0.01). The differences between the AUC for spleen STEmean and liver FibroScan in liver fibrosis staging were not statistically significant when the groups categorized by S = 2 and S = 4 (P = 0.146 and P = 0.052). But when categorized by S = 3, the evaluating performance of liver FibroScan was better (P = 0.004). CONCLUSION: STEmean of spleen is applicable in indirect predicting fibrosis stage in patients with CHB.

scholarly journals Association of STAT3 and STAT4 polymorphisms with susceptibility to chronic hepatitis B virus infection and risk of hepatocellular carcinoma: a meta-analysis

2019 ◽  
Vol 39 (6) ◽  
Author(s):  
Han Shi ◽  
Hongyan He ◽  
Suvash Chandra Ojha ◽  
Changfeng Sun ◽  
Juan Fu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Meta Analysis ◽  
Hbv Infection ◽  
Chronic Hbv Infection ◽  
B Virus ◽  
Chronic Hbv

Abstract Background: It has been reported that polymorphisms of signal transducer and activator of transcription (STAT) 3 and STAT4 might be associated with susceptibility to hepatitis B virus (HBV) infection and risk of chronic hepatocellular carcinoma (HCC). Owing to limitation of sample size and inconclusive results, we conducted a meta-analysis to clarify the association. Methods: We identified relevant studies by a systematic search of Medline/PubMed, Embase, Web of Science and the Cochrane Library up to 20 February 2019. The strength of the association measured by odds ratios (OR) with 95% confidence intervals (CIs) was studied. All the statistical analyses were conducted based on Review Manager 5.3 software. Results: A total of 5242 cases and 2717 controls from five studies were included for the STAT3 polymorphism, 5902 cases and 7867 controls from nine studies for the STAT4 polymorphism. Our results suggested that STAT3 rs1053004 polymorphism was a significant risk factor of chronic HBV infection (C vs. T: OR = 1.17, 95% CI: 1.07–1.29, PA=0.0007; CC + CT vs. TT: OR = 1.38, 95% CI: 1.09–1.76, PA=0.008). Validation with all the genetic models revealed that rs7574865 polymorphism of STAT4 gene was closely associated with chronic HBV infection (PA<0.01) and chronic hepatitis B (CHB)-related HCC (PA<0.05). Meanwhile, the authenticity of the above meta-analysis results was confirmed by trial sequential analysis (TSA). Conclusions: The meta-analysis showed that STAT3 rs1053004 polymorphism may be the risk for developing chronic HBV infection but not associated with HCC. The present study also indicates that STAT4 rs7574865 polymorphism increased the risk of chronic HBV infection and HCC.

scholarly journals Serum pentraxin 3 as a biomarker of hepatocellular carcinoma in chronic hepatitis B virus infection

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Huan Deng ◽  
Xiude Fan ◽  
Xiaoyun Wang ◽  
Lu Zeng ◽  
Kun Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Early Stage ◽  
Hbv Infection ◽  
Healthy Controls ◽  
Pentraxin 3 ◽  
Chronic Hbv Infection ◽  
Chronic Hepatitis B Virus ◽  
B Virus ◽  
Chronic Hbv

AbstractBiomarkers for early diagnosis of hepatocellular carcinoma (HCC) are needed in chronic hepatitis B virus (HBV) infection, a leading cause of HCC. We evaluated whether measurement of serum pentraxin 3 (PTX3) could improve diagnosis of HCC in chronic HBV infection. Data from patients with HBV-related chronic hepatitis (n = 159), cirrhosis (n = 99) and HCC (n = 107), and healthy controls (n = 151) were analyzed. Serum PTX3 concentration was measured by immunoassay. Area under the receiver operating characteristic curve (AUC) was applied to assess diagnostic accuracy. PTX3 levels were significantly higher in HBV patients than in healthy controls (P < 0.001) and in HCC than in chronic hepatitis (P < 0.001) or cirrhosis patients (P < 0.001). PTX3 was an independent risk factor of HCC [odds ratio (OR) 1.617, P < 0.001] and could distinguish HCC in chronic HBV infection [cutoff 9.231 ng/mL, AUC 0.929 with 95% confidence interval (CI) of 0.898–0.953], including α-fetoprotein (AFP) negative [cutoff 8.985 ng/mL, AUC (95%CI) 0.947 (0.908–0.973)] and early-stage HCC [cutoff 9.359 ng/mL, AUC (95%CI) 0.920 (0.885–0.947)]. Combination of PTX3 with AFP improved the discrimination of early HCC from chronic HBV infection [AUC (95%CI) 0.948 (0.918–0.970)]. In short, PTX3 measurement could identify HCC, including AFP-negative and early-stage HCC, in chronic HBV infection.

Accuracy of 2D shear wave elastography in the diagnosis of liver fibrosis in patients with chronic hepatitis C

2018 ◽  
Vol 46 (5) ◽  
pp. 319-327 ◽  
Author(s):  
Tamami Abe ◽  
Hidekatsu Kuroda ◽  
Yudai Fujiwara ◽  
Yuichi Yoshida ◽  
Akio Miyasaka ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Shear Wave ◽  
Chronic Hepatitis C ◽  
Shear Wave Elastography
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