Noninvasive methods to assess liver disease in patients with hepatitis B or C |
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| Authors: | Castera Laurent |
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| Affiliation: | 1. Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping District, Beijing 102206, China;2. National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100052, China;1. Royal Free Sheila Sherlock Liver Centre, Royal Free Hospital and UCL Institute of Liver and Digestive Health, London, UK;2. Hepatic Hemodynamic Laboratory, Hospital Clínic-IDIBAPS, University of Barcelona, and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain;1. Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan;3. Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan;7. Division of Gastroenterology and Hepatology, Henry Ford Health System, Detroit, Michigan;4. Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia;6. Center for Health Research, Geisinger Health System, Danville, Pennsylvania;5. Center for Health Research, Kaiser Permanente–Northwest, Portland, Oregon;1. Service d''Hépatologie, Hôpital Beaujon, and INSERM Unit CRB3, Clichy, France;2. Auckland City Hospital, Auckland, New Zealand;3. Liver Unit, Hospital General Universitari Vall d''Hebron and CIBERehd, Barcelona, Spain;4. Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA, USA;5. Monash University and Monash Medical Centre, Melbourne, VIC, Australia;6. Weill Cornell Medical College, New York, NY, USA;7. Vanderbilt University, Nashville, TN, USA;8. AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece;9. Gilead Sciences, Foster City, CA, USA;10. University of Toronto, Toronto, ON, Canada;1. Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, First Affiliated Hospital, Xi''an Jiaotong University, Xi''an City, Shaanxi Province, China;2. National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine, First Affiliated Hospital, Xi''an Jiaotong University, Xi''an City, Shaanxi Province, China;3. Institute of Advanced Surgical Technology and Engineering, Xi''an Jiaotong University, Xi''an City, Shaanxi Province, China;4. Department of Hepatobiliary Surgery, First Affiliated Hospital, Xi''an Jiaotong University, Xi''an City, Shaanxi Province, China;1. Division of Gastroenterology and Hepatology, Humanity and Health Medical Centre, Hong Kong SAR, China;3. State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China;4. Second Liver Cirrhosis Diagnosis and Treatment Center, 302 Hospital, Beijing, China;6. Liver Failure Treatment and Research Centre, 302 Hospital, Beijing, China;5. Hong Kong Molecular Pathology Diagnostic Centre, Hong Kong SAR, China |
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| Abstract: | The prognosis and management of patients with chronic viral hepatitis B and C depend on the amount and progression of liver fibrosis and the risk for cirrhosis. Liver biopsy, traditionally considered to be the reference standard for staging of fibrosis, has been challenged over the past decade by the development of noninvasive methodologies. These methods rely on distinct but complementary approaches: a biologic approach, which quantifies serum levels of biomarkers of fibrosis, and a physical approach, which measures liver stiffness by ultrasound or magnetic resonance elastography. Noninvasive methods were initially studied and validated in patients with chronic hepatitis C but are now used increasingly for patients with hepatitis B, reducing the need for liver biopsy analysis. We review the advantages and limitations of the noninvasive methods used to manage patients with chronic viral hepatitis B or C infection. |
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