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Performance of transient elastography assessing fibrosis of single hepatitis B virus infection: a systematic review and meta-analysis of a diagnostic test

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Abstract

Introduction

Transient elastography has good diagnostic accuracy for predicting fibrosis and cirrhosis related to hepatitis B virus. However, the enrolled subjects in some studies have also included chronic hepatitis B patients with chronic hepatitis C coinfection or other etiologies of liver diseases. This might under- or overestimate the role of transient elastography in chronic hepatitis B patients.

Methods

A systematic review was conducted on records in PubMed, EMBASE and the Cochrane Library electronic databases until 31 December 2013. We systematically assessed the effectiveness and accuracy of transient elastography for predicting the fibrosis and cirrhosis of the single hepatitis B virus. The questionnaire for quality assessment of diagnostic accuracy studies was used.

Results

In this meta-analysis, out of 257 articles evaluated for eligibility, 165 satisfied the predetermined inclusion criteria for meta-analysis. Eventually, our final data set for the meta-analysis contained 19 studies. The areas under the summary receiver-operating characteristic curve for transient elastography of significant fibrosis and cirrhosis were 0.8225 and 0.9108, respectively. The pooled diagnostic odds ratios for transient elastography of significant fibrosis and cirrhosis were 11.19 (95 % CI 6.63–18.89) and 26.87 (95 % CI 17.88–40.38), respectively. In Europe, the areas of significant fibrosis and cirrhosis were 0.803 and 0.905; those in Asia were 0.871 and 0.914, respectively.

Conclusions

Based on this meta-analysis we claim that liver stiffness measurement using transient elastography has good diagnostic accuracy for predicting single hepatitis B virus-related significant fibrosis and cirrhosis, especially in Asian populations.

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Abbreviations

LSM:

Liver stiffness measurement

TE:

Transient elastography

CHC:

Chronic hepatitis C

CHB:

Chronichepatitis B

HBV:

Hepatitis B virus

IQR:

Interquartile range

HCV:

Hepatitis C virus

HDV:

Hepatitis D virus

BMI:

Body mass index

QUADAS:

Quality assessment of diagnostic accuracy studies

PPV:

Positive predictive value

NPV:

Negative predictive value

SROC:

Summary receiver-operating characteristics

DOR:

Diagnostic odds ratio

CI:

Confidence interval

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Acknowledgements

This research was supported in part by the National Natural Science Foundation, Grant No. 71073176, in China, awarded to HBL. The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.

Compliance with ethical requirements and Conflict of interest

We were not required to obtain institutional review board approval for this study. All data contained in the study were derived from the articles published in public, which had been identified in accordance with the ethical standards of the institutional and/or national research committee and the 1975 Helsinki declaration. Xueying Xu, Yang Su, Ruixiang Song, Yang Sheng, Wensi Ai, Xiaofei Wu and Hongbo Liu declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Epidemiology and Health Statistics, School of Public Health, China Medical University, Shenyang, 110001, People’s Republic of China

    Xueying Xu, Yang Su, Yang Sheng, Wensi Ai, Xiaofei Wu & Hongbo Liu

  2. Department of Urinary Surgery, Changhai Hospital, Shanghai, People’s Republic of China

    Ruixiang Song

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  1. Xueying Xu
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Correspondence to Hongbo Liu.

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Xu, X., Su, Y., Song, R. et al. Performance of transient elastography assessing fibrosis of single hepatitis B virus infection: a systematic review and meta-analysis of a diagnostic test. Hepatol Int 9, 558–566 (2015). https://doi.org/10.1007/s12072-015-9643-z

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