Differing threshold levels of hepatitis B virus (HBV) DNA and alanine aminotransferase (ALT) are recommended by international guidelines for commencement of antiviral therapy.
These guidelines advocate therapy for patients with significant fibrosis.
Dr Faisal Sanai and colleagues from Saudi Arabia assessed the accuracy of these guideline-defined thresholds in identifying patients with ≥F2 fibrosis.
The team applied the European (EASL), Asian-Pacific (AASLD), American (APASL), and United States Panel Algorithm (USPA) criteria to 366 consecutive hepatitis B e antigen–negative patients with liver biopsy samples.
|31% of patients had ≥F2 fibrosis|
|Clinical Gastroenterology & Hepatology|
Overall, 31% of patients had ≥F2 fibrosis, which was more frequent among patients who fulfilled any guideline criteria.
In applying the EASL, AASLD, APASL, and USPA criteria, sensitivity and specificity values for detection of ≥F2 fibrosis were 46%, 59%, 56%, and 46% and 82%, 74%, 77%, and 82%, respectively.
The team found that the EASL criteria and USPA criteria performed better than APASL, and significantly better than the AASLD criteria.
Dr Faisal's team concludes, "In hepatitis B e antigen–negative patients with chronic hepatitis, the EASL, AASLD, APASL, and USPA criteria identify patients with ≥F2 fibrosis with low levels of accuracy."
"However, the EASL and USPA criteria are the most accurate for identification of these patients."