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2024年7月14日日曜日
#VitalStream Non-Invasive Assessment of Liver Fibrosis in Hepatitis B Patients #VitalStream_caretaker #Labtech_Holter #Arteriograph_Tensiomed
Non-Invasive Assessment of Liver Fibrosis in Hepatitis
B Patients
Chinmay Bera * ,
Division of Gastroenterology, University Health Network Toronto, Toronto General Hospital, 200 Elizabeth Street,
Abstract: The aim of this review is to provide updated information on the clinical use of non-invasive
serum and imaging-based tests for fibrosis assessment in chronic hepatitis B (CHB) virus infection.
In recent years, non-invasive tests (NIT) have been increasingly used to determine eligibility for
treatment. Liver biopsy is still considered the gold standard for assessing inflammatory activity and
fibrosis staging, but it is an invasive procedure with inherent limitations. Simple serum markers
such as APRI and FIB-4 are limited by indeterminate results but remain useful initial tests for
fibrosis severity if imaging elastography is not available. Point-of-care US-based elastography
techniques, such as vibration-controlled transient elastography or 2D shear wave elastography, are
increasingly available and have better accuracy than simple serum tests for advanced fibrosis or
cirrhosis, although stiffness cut-offs are variable based on E-antigen status and inflammatory activity.
Current NITs have poor diagnostic performance for following changes in fibrosis with antiviral
therapy. However, NITs may have greater clinical utility for determining prognosis in patients
with CHB that have advanced disease, especially for the development of hepatocellular carcinoma
and/or liver decompensation. Algorithms combining serum and imaging NITs appear promising for
advanced fibrosis and prognostic risk stratification.
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