Are non‐invasive fibrosis markers for chronic hepatitis B reliable in sub‐Saharan Africa?

• DOI: 10.1111/liv.13393
• Publication Date: 2017-02-21T21:32:47Z
• Authors: Hailemichael Desa...; Hanna Aberra; Nega Berhe; Svein G. Gundersen; Asgeir Johannessen
• Keywords: Transient elastography; Hepatitis B; Hepatitis C

In the absence of liver biopsy, World Health Organization recommends non-invasive tests, such as aspartate aminotransferase to platelet ratio index and FIB-4, assess fibrosis in patients with chronic hepatitis B. However, these tests are not well validated sub-Saharan Africa. Recently, a new marker, gamma-glutamyl transpeptidase ratio, was found be more accurate an African setting, but this needs confirmation other cohorts.A treatment program for B initiated Addis Ababa, Ethiopia, 2015. Non-invasive were compared transient elastography (Fibroscan 402, Echosense, France) using following thresholds: no (≤7.9 kPa), significant (>7.9 kPa) cirrhosis (>11.7 kPa). The diagnostic accuracy estimated by calculating area under receiver operating characteristics curve.Of 582 treatment-naïve patients, 141 (24.2%) had 90 (15.5%) cirrhosis. curve index, FIB-4 high both diagnose (0.79 [95% CI 0.75-0.84], 0.79 0.80 0.75-0.85]) (0.86 0.81-0.91], 0.86 0.87 0.82-0.91]). specificity all (94%-100%); however, sensitivity poor detect (10%-45%) (10%-36%).Aspartate good properties East low, only 10% detected at recommended threshold.