Ankur Shah1, Rathi Chetan2 and Shah Jayshri A3*
1Consultant Surgeon, East Kent University Hospitals NHS Foundation Trust, Ashford, UK and Director, Ansh Liver Clinic, Andheri West, Mumbai, India
2Department of Gastroenterology, Jagjivan Ram Hospital, Western Railways, Mumbai Central, Maharashtra, India
3Consultant Gastroenterologist and Hepatologist, East Kent University Hospitals NHS Foundation Trust, Ashford, UK and Director, Ansh Liver Clinic, Andheri West, Mumbai, India
*Corresponding Author: Shah Jayshri A, Consultant Gastroenterologist and Hepatologist, East Kent University Hospitals NHS Foundation Trust, Ashford, UK and Director, Ansh Liver Clinic, Andheri West, Mumbai, India.
Received: July 09, 2020; Published: July 28, 2020
Objectives: To analyse the Role of Fibroscan (FS) and non-invasive markers to assess hepatic fibrosis and steatosis at initial presentation of patients with Hepatitis B.
Methods: An observational prospective study of patients with chronic hepatitis B (CHB) evaluated at single Liver Clinic, Mumbai from April 2014-March 2017. Serological markers, transient elastography (fibroscan) for HF, APRI, FIB-4, AST/ALT ratio and E-score were analyzed. Controlled attenuation parameter (CAP) score on fibroscan was used for grading of hepatic steatosis. Patients were categorized into 2 groups: No significant fibrosis (< F2), significant fibrosis (> F2) group. AST/ALT ratio was divided into 2 groups: No significant fibrosis for ≤ 1, significant fibrosis > 1.
Results: 178 study patients with male preponderance (68%), had asymptomatic infection, 24 patients were symptomatic; ascites (7), variceal bleeding (11) and hepatocellular carcinoma (8). 139 patients underwent fibroscan, 80 had HS on CAP score. 40/100 patients with normal AST and ALT had significant fibrosis (> F2) on fibroscan. Amongst noninvasive biochemical tools, only FIB-4 had significant correlation with fibroscan, (p < 0.05). The ROC curve areas (AUROC) of FIB-4, APRI and AST/ALT ratio that differentiated patients with significant HF from without fibrosis was 0.704, 0.674, 0.567, respectively. The sensitivity and specificity of FIB-4, APRI and AST/ALT ratio to differentiate patients with significant HF from those without was 42.6% and 92.3%, 72.1% and 60.2%, 29.5% and 83.3%, respectively.
Conclusion: Fibroscan and FIB-4 had significant correlation of HS in CHB patients. These can be used as non-invasive modalities to monitor HS in CHB patients.
Keywords: Hepatitis B; Hepatic Fibrosis; Hepatic Steatosis; Transient Elastography
Citation: Shah Jayshri A., et al. “Role of Fibroscan and Non Invasive Markers to Assess Hepatic Fibrosis and Steatosis at Initial Presentation of Patients with Hepatitis B". Acta Scientific Gastrointestinal Disorders 3.8 (2020): 16-23.
Copyright: © 2020 Shah Jayshri A., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.