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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Gastroenterology 1/2014

FibroSURE as a noninvasive marker of liver fibrosis and inflammation in chronic hepatitis B

Zeitschrift:
BMC Gastroenterology > Ausgabe 1/2014
Autoren:
Marija Zeremski, Rositsa B Dimova, Samantha Benjamin, Jessy Makeyeva, Rhonda K Yantiss, Maya Gambarin-Gelwan, Andrew H Talal
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-230X-14-118) contains supplementary material, which is available to authorized users.

Competing interests

This study was funded in part through the Fellows Research Program sponsored by Bristol-Myers Squibb and Laboratory Corporation of America for performance of the Fibrosure test.

Authors’ contributions

MZ and AHT designed the study. MZ, SB, JM, and MG-G acquired the data. MZ, RBD, RKY, and AHT analyzed and interpreted the data. RBD performed statistical analysis of the data. MZ and AHT wrote the manuscript. All authors read and approved the final version of the manuscript.

Abstract

Background

Noninvasive markers of liver fibrosis have not been extensively studied in patients with chronic hepatitis B virus (HBV) infection. Our aim was to evaluate the capacity of FibroSURE, one of the two noninvasive fibrosis indices commercially available in the United States, to identify HBV infected patients with moderate to severe fibrosis.

Methods

Forty-five patients who underwent liver biopsy at a single tertiary care center were prospectively enrolled and had FibroSURE performed within an average interval of 11 days of the biopsy.

Results

Of the 45 patients, 40% were Asian, 40% were African American, and 13% were Caucasian; 27% were co-infected with HIV and 67% had no or mild fibrosis. We found FibroSURE to have moderate capacity to discriminate between patients with moderate to high fibrosis and those with no to mild fibrosis (area under receiver operating characteristic [AUROC] curve = 0.77; 95% confidence interval [CI] [0.61, 0.92]). When we combined the fibrosis score determined by FibroSURE with aspartate aminotransferase (AST) measurements and HIV co-infection status, the discriminatory ability significantly improved reaching an AUROC of 0.90 (95% CI [0.80, 1.00]). FibroSURE also had a good ability to differentiate patients with no or mild from those with moderate to high inflammation (AUROC = 0.83; 95% CI [0.71, 0.95]).

Conclusions

FibroSURE in combination with AST levels has an excellent capacity to identify moderate to high fibrosis stages in chronic HBV-infected patients. These data suggest that FibroSURE may be a useful substitute for liver biopsy in chronic HBV infection.
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