Non-Invasive Assessment of Liver Fibrosis in Hepatitis B Patients

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 treatmen...

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Bibliographic Details
Published in:Journal of clinical medicine 2024-02, Vol.13 (4), p.1046
Main Authors: Bera, Chinmay, Hamdan-Perez, Nashla, Patel, Keyur
Format: Article
Language:English
Subjects:
Biological markers
Biomarkers
Biopsy
Blood platelets
Complications and side effects
Diagnosis
Evaluation
Fibrosis
Hepatitis B
Hepatitis C
Infections
Liver cancer
Liver cirrhosis
Liver diseases
Meta-analysis
Mortality
Risk factors
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Summary: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.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm13041046