Role of Noninvasive Fibrosis Methods in Management of Chronic Hepatitis B Virus

Chronic hepatitis B represents a major public health burden. One quarter of patients with chronic hepatitis B will progress to cirrhosis without treatment. According to the current hepatitis B guidelines, treatment is based upon alanine aminotransferase (ALT) elevation and hepatitis B virus (HBV) DNA levels, along with liver fibrosis staging. Liver biopsy still represents the gold standard for the diagnosis and staging of liver fibrosis. However, this method has several limitations like invasiveness, sampling variations, pain, time commitments, and bleeding. In response to this concern, in the last decade, a large amount of noninvasive methods have emerged offering promising diagnostic capabilities. These techniques include serum markers of fibrosis and radiological tests. In the present review, we discuss the performance characteristics and advantages of using noninvasive methods to diagnose and stage liver fibrosis in patients with chronic hepatitis B and its utility in clinical practice.