Accuracy of noninvasive methods for the diagnosis of liver fibrosis in children with chronic viral hepatitis

BMC Gastroenterology

Research Article

SA Sharaf¹  A Elsharkawy²  MS El-Raziky³  H Taher³  A Enayet⁴  A ElShahawy⁵ 

[1] Chemical Pathology, Faculty of Medicine, Cairo University, Giza City, Egypt;Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Giza City, Egypt;Pediatrics and Pediatric Hepatology, Faculty of Medicine, Cairo University, Giza City, Egypt;Pediatrics and Pediatric Hepatology, Faculty of Medicine, Cairo University, Giza City, Egypt;Department of Pediatrics, Kasr Alainy Medical School, Faculty of Medicine, Cairo University, Giza City, Egypt;Pediatrics in National Hepatology and Tropical Medicine Institiute, Cairo, Egypt;

关键词: Chronic hepatitis;    APRI;    Hyaluronic acid;    Transient elastography;    Liver biopsy;   

DOI  :  10.1186/s12876-022-02570-w

 received in 2022-05-11, accepted in 2022-11-07,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundLiver biopsy is the reference standard for assessing liver fibrosis. Moreover, it is an invasive procedure. Transient elastography (TE) is an accurate, noninvasive method for evaluating liver stiffness as a surrogate of liver fibrosis. The aspartate aminotransferase to platelet ratio index (APRI) and Hyaluronic acid (HA) are noninvasive alternatives to liver biopsy for detecting hepatic fibrosis. This study aimed to identify the accuracy of APRI, HA, and TE concerning liver biopsy in children with chronic viral hepatitis.MethodsThis cross-sectional study included 50 children, 5–18 years with chronic viral hepatitis B (HBV) or hepatitis C (HCV) who underwent liver biopsy within nine months of laboratory tests, determining APRI & performing TE. Twenty healthy children of age and sex-matching patients were included as a control group for the serum HA levels.ResultsThe histopathological findings of the studied cases showed seven cases with (F0) fibrosis, 36 cases with mild (F1,2), two children with moderate (F3,4), and five children with severe (F5,6). The median (IQR) of steatosis was 4 (three had HCV). When correlating TE, APRI, and HA values in all cases with their laboratory data, there was a positive correlation between ALT and APRI values (P-value = 0.000), a positive correlation between AST and HA values (P-value = 0.02), and a negative correlation between stiffness and APRI.The sensitivity of HA, APRI, and TE compared to fibrosis detected by histopathology was 60.5, 65.1, and 60.5%, and their specificity was 71.4, 57.1, and 85.7%, respectively. TE was significantly higher in a group with (moderate to severe) fibrosis.ConclusionAPRI, HA, and TE are good indicators of the presence of fibrosis almost with the same accuracy. TE is the only method to differentiate mild cases from those with significant fibrosis.

【 授权许可】

CC BY   
© The Author(s) 2022