Hepatitis B: are non-invasive markers of liver fibrosis reliable?
Article first published online: 23 DEC 2013
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Special Issue: Proceedings of the 7th Paris Hepatitis Conference International Conference of the Management of Patients with Viral Hepatitis, 13–14 January 2014, Paris, France. Guest Editors: Patrick Marcellin and Tarik Asselah. The publication of this supplement was supported by an unrestricted educational grant from Gilead, Janssen Therapeutics, Janssen, Bristol-Myers Squibb, Roche, Boehringer Ingelheim, Merck, AbbVie, Novartis, Idenix and Alios.
Volume 34, Issue Supplement s1, pages 91–96, February 2014
How to Cite
Castera, L. (2014), Hepatitis B: are non-invasive markers of liver fibrosis reliable?. Liver International, 34: 91–96. doi: 10.1111/liv.12393
- Issue published online: 23 DEC 2013
- Article first published online: 23 DEC 2013
- Manuscript Accepted: 25 OCT 2013
- Manuscript Received: 22 OCT 2013
- HBV ;
- transient elastography;
Liver biopsy, which was traditionally considered to be the gold standard for the staging of fibrosis, has been challenged in the past decade by non-invasive techniques. These techniques rely on two distinct but complementary approaches: a ‘biological’ approach, based on the quantification of biomarkers of fibrosis in serum, and a ‘physical’ approach, based on the measurement of liver stiffness using elastography-based technologies. Advantages of serum biomarkers include their high applicability (>95%) and good reproducibility. However, as none are liver specific their results can be influenced by comorbid conditions (risk of false positive results with FibroTest® in patients with Gilbert's syndrome or with APRI in case of acute hepatitis). Transient elastograpy has the advantages of being a user's friendly procedure that can be performed at the bedside or in an outpatient clinic with high performance for detecting cirrhosis. However, its applicability is lower (80%) than that of serum biomarker (particularly in case of ascites, obesity and limited operator experience) with the risk of false positive results in case of ALT flares. Although these non-invasive methods were initially developed and validated in patients with chronic hepatitis C, they are now increasingly used in patients with hepatitis B, reducing the need for liver biopsy.