Prognostic value of the combined use of transient elastography and fibrotest in patients with chronic hepatitis B

Background & AimsLiver stiffness (LS) measurement using transient elastography and the FibroTest (FT) are alternatives to liver biopsy (LB) in assessing liver fibrosis. We investigated the prognostic role of the combined use of LS and FT in predicting liver-related events (LREs) in patients with chronic hepatitis B (CHB). MethodsConsecutive patients with CHB who underwent LB, along with LS and FT on the same day were recruited. LRE was defined as hepatic decompensation, hepatocellular carcinoma (HCC) or liver-related death. ResultsA total of 151 patients (86 male) were analyzed. During follow-up (median 59.9months), overall 18 (11.9%) patients experienced LREs. The areas under receiver-operating characteristic curves of LS, FT, LS+FT and LSxFT in predicting LRE were 0.701, 0.668, 0.702 and 0.741 respectively. After adjusting for age and histological fibrosis staging, significant variables in univariate analysis (both P<0.05), LS+FT and LSxFT were independent predictors of LREs with hazard ratios (HRs) of 1.080 and 1.126 (all P<0.05) respectively. When subjects were divided into three groups according to quartile stratification (low quartile, interquartile and high quartile) using LS+FT and LSxFT, cumulative LRE development rate significantly increased with a corresponding increase in value among three groups respectively (log-rank test, all P<0.05). ConclusionThe combined use of LS and FT significantly predicted forthcoming LRE development, but with only a slight additional benefit compared to LS or FT alone.