Serum aminotransferase levels instead of etiology affects the accuracy of transient elastography in chronic viral hepatitis patients

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Abstract

Background and Aim: It is still uncertain whether the accuracy of transient elastography (TE) in predicting the fibrosis stage is similar in chronic hepatitis B (CHB) and chronic hepatitis C (CHC). The present study was carried out to evaluate whether the underlying cause of chronic viral hepatitis affects the predictive accuracy of TE. Methods: Patients with CHB or CHC who were admitted for a liver biopsy were enrolled. Patients underwent TE and laboratory tests on the same day as the liver biopsy. The predictive accuracy was analyzed by comparing the areas under the receiver-operating characteristic curves (AUCs). Results: Two-hundred and seven patients were enrolled, comprising 121 CHB patients and 86 CHC patients). The patients were aged 44±14 years, and 121 (58.5%) of them were men. AUCs for predicting significant fibrosis were significantly lower in CHB patients than in CHC patients (P=0.043). The serum alanine aminotransferase (ALT) level was associated with overestimation and underestimation of the fibrosis stage, while the cause of chronic hepatitis was not. AUCs for predicting significant fibrosis were significantly lower in patients with ALT levels >70IU/L (AUC, 0.830; 95% CI, 0.742-0.898) than in patients with ALT levels ≤70IU/L (0.944; 0.882-0.979; P=0.015). Conclusions: Although the predictive accuracy of TE in predicting significant fibrosis differed significantly with the cause of chronic hepatitis, this difference was due to the degree of serum ALT levels rather than to the cause of hepatitis itself. Avoiding performing TE in patients with elevated ALT levels is recommended to guarantee the predictive accuracy of TE.

Original languageEnglish
Pages (from-to)492-500
Number of pages9
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume26
Issue number3
DOIs
Publication statusPublished - 2011 Jan 1

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Elasticity Imaging Techniques
Chronic Hepatitis
Transaminases
Serum
Alanine Transaminase
Chronic Hepatitis B
Chronic Hepatitis C
Fibrosis
Area Under Curve
Biopsy
Liver
ROC Curve
Hepatitis

Keywords

  • Alanine aminotransferase
  • FibroScan
  • Liver stiffness
  • Necroinflammation

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

@article{5adee981012e4e7382494100e1a1a95f,
title = "Serum aminotransferase levels instead of etiology affects the accuracy of transient elastography in chronic viral hepatitis patients",
abstract = "Background and Aim: It is still uncertain whether the accuracy of transient elastography (TE) in predicting the fibrosis stage is similar in chronic hepatitis B (CHB) and chronic hepatitis C (CHC). The present study was carried out to evaluate whether the underlying cause of chronic viral hepatitis affects the predictive accuracy of TE. Methods: Patients with CHB or CHC who were admitted for a liver biopsy were enrolled. Patients underwent TE and laboratory tests on the same day as the liver biopsy. The predictive accuracy was analyzed by comparing the areas under the receiver-operating characteristic curves (AUCs). Results: Two-hundred and seven patients were enrolled, comprising 121 CHB patients and 86 CHC patients). The patients were aged 44±14 years, and 121 (58.5{\%}) of them were men. AUCs for predicting significant fibrosis were significantly lower in CHB patients than in CHC patients (P=0.043). The serum alanine aminotransferase (ALT) level was associated with overestimation and underestimation of the fibrosis stage, while the cause of chronic hepatitis was not. AUCs for predicting significant fibrosis were significantly lower in patients with ALT levels >70IU/L (AUC, 0.830; 95{\%} CI, 0.742-0.898) than in patients with ALT levels ≤70IU/L (0.944; 0.882-0.979; P=0.015). Conclusions: Although the predictive accuracy of TE in predicting significant fibrosis differed significantly with the cause of chronic hepatitis, this difference was due to the degree of serum ALT levels rather than to the cause of hepatitis itself. Avoiding performing TE in patients with elevated ALT levels is recommended to guarantee the predictive accuracy of TE.",
keywords = "Alanine aminotransferase, FibroScan, Liver stiffness, Necroinflammation",
author = "Cho, {Hye Jin} and Seo, {Yeon Seok} and Lee, {Kwang Gyun} and Hyun, {Jong Jin} and Hyonggin An and Bora Keum and Kim, {Ji Hoon} and Yim, {Hyung Joon} and Jeen, {Yoon Tae} and Lee, {Hong Sik} and Hoon-Jai Chun and Soon-Ho Um and Kim, {Chang Duck} and Ryu, {Ho Sang}",
year = "2011",
month = "1",
day = "1",
doi = "10.1111/j.1440-1746.2010.06419.x",
language = "English",
volume = "26",
pages = "492--500",
journal = "Journal of Gastroenterology and Hepatology (Australia)",
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T1 - Serum aminotransferase levels instead of etiology affects the accuracy of transient elastography in chronic viral hepatitis patients

AU - Cho, Hye Jin

AU - Seo, Yeon Seok

AU - Lee, Kwang Gyun

AU - Hyun, Jong Jin

AU - An, Hyonggin

AU - Keum, Bora

AU - Kim, Ji Hoon

AU - Yim, Hyung Joon

AU - Jeen, Yoon Tae

AU - Lee, Hong Sik

AU - Chun, Hoon-Jai

AU - Um, Soon-Ho

AU - Kim, Chang Duck

AU - Ryu, Ho Sang

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Background and Aim: It is still uncertain whether the accuracy of transient elastography (TE) in predicting the fibrosis stage is similar in chronic hepatitis B (CHB) and chronic hepatitis C (CHC). The present study was carried out to evaluate whether the underlying cause of chronic viral hepatitis affects the predictive accuracy of TE. Methods: Patients with CHB or CHC who were admitted for a liver biopsy were enrolled. Patients underwent TE and laboratory tests on the same day as the liver biopsy. The predictive accuracy was analyzed by comparing the areas under the receiver-operating characteristic curves (AUCs). Results: Two-hundred and seven patients were enrolled, comprising 121 CHB patients and 86 CHC patients). The patients were aged 44±14 years, and 121 (58.5%) of them were men. AUCs for predicting significant fibrosis were significantly lower in CHB patients than in CHC patients (P=0.043). The serum alanine aminotransferase (ALT) level was associated with overestimation and underestimation of the fibrosis stage, while the cause of chronic hepatitis was not. AUCs for predicting significant fibrosis were significantly lower in patients with ALT levels >70IU/L (AUC, 0.830; 95% CI, 0.742-0.898) than in patients with ALT levels ≤70IU/L (0.944; 0.882-0.979; P=0.015). Conclusions: Although the predictive accuracy of TE in predicting significant fibrosis differed significantly with the cause of chronic hepatitis, this difference was due to the degree of serum ALT levels rather than to the cause of hepatitis itself. Avoiding performing TE in patients with elevated ALT levels is recommended to guarantee the predictive accuracy of TE.

AB - Background and Aim: It is still uncertain whether the accuracy of transient elastography (TE) in predicting the fibrosis stage is similar in chronic hepatitis B (CHB) and chronic hepatitis C (CHC). The present study was carried out to evaluate whether the underlying cause of chronic viral hepatitis affects the predictive accuracy of TE. Methods: Patients with CHB or CHC who were admitted for a liver biopsy were enrolled. Patients underwent TE and laboratory tests on the same day as the liver biopsy. The predictive accuracy was analyzed by comparing the areas under the receiver-operating characteristic curves (AUCs). Results: Two-hundred and seven patients were enrolled, comprising 121 CHB patients and 86 CHC patients). The patients were aged 44±14 years, and 121 (58.5%) of them were men. AUCs for predicting significant fibrosis were significantly lower in CHB patients than in CHC patients (P=0.043). The serum alanine aminotransferase (ALT) level was associated with overestimation and underestimation of the fibrosis stage, while the cause of chronic hepatitis was not. AUCs for predicting significant fibrosis were significantly lower in patients with ALT levels >70IU/L (AUC, 0.830; 95% CI, 0.742-0.898) than in patients with ALT levels ≤70IU/L (0.944; 0.882-0.979; P=0.015). Conclusions: Although the predictive accuracy of TE in predicting significant fibrosis differed significantly with the cause of chronic hepatitis, this difference was due to the degree of serum ALT levels rather than to the cause of hepatitis itself. Avoiding performing TE in patients with elevated ALT levels is recommended to guarantee the predictive accuracy of TE.

KW - Alanine aminotransferase

KW - FibroScan

KW - Liver stiffness

KW - Necroinflammation

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U2 - 10.1111/j.1440-1746.2010.06419.x

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JO - Journal of Gastroenterology and Hepatology (Australia)

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