The value of fibrotest and elastography in the detection of fibrosis due to chronic hepatitis B

Hepatitis B is an important epidemiological problem in that it is a chronic infectious disease that is frequently seen in the world. Since serious complications such as hepatocellular carcinoma (HCC) and cirrhosis occur in chronic cases, diagnosis and follow-up are important. In patients with chronic hepatitis B (CHB), the stage of liver fibrosis has prognostic significance as well as the indication for treatment in selected cases. Traditionally, liver biopsy is considered the gold standard for determining fibrosis stage. However, the ability of liver biopsy to vary with histopathological evaluation and the fact that it is invasive and open to complications is limiting the benefit of biopsy. Currently, there are many researches about noninvasive tests that can take place in liver biopsy. Among them, the diagnostic value of FibroTest and Acustic Radiation Force Impulse (ARFI) quantification elastography has been our research topic. Thirty-two patients who were referred to our hospital for CHB and who had liver biopsy within the last week were included in the study. Blood was drawn from the patients to study FibroTest and ARFI elastography was examined within the same day. Twenty-eight pathologies, 30 FibroTest and 31 ARFI elastography results which compliant with the study criteria were evaluated. The diagnostic performance of noninvasive tests was evaluated based on pathology result. Patients were divided into two groups with (Group 2: Ishak stage F3-4-5-6) and without (Group 1: Ishak stage F0-1-2) significant fibrosis. The area under the ROC curve (AUROC) to distinguish significant fibrosis was observed 0.56 for FibroTest and showed poor diagnostic performance, while ARFI elastography showed good diagnostic performance with value of 0.92 . There was no correlation between the FibroTest and ARFI elastography in the correlation test. Significant correlation was found between pathology result and ARFI elastography We concluded that ARFI elastography showed good diagnostic performance while FibroTest was found to be insufficient in distinguishing significant fibrosis in CHB in our study.