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

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.