Volume 82, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Liver fibrosis (LF) must be assessed before talking treatment decisions in hepatitis B. In Burkina Faso, liver biopsy (LB) remains the “gold standard” method for this purpose. Access to treatment might be simpler if reliable alternative techniques for LF evaluation were available. The hepatitis B virus (HBV)-infected patients who underwent LB was invited to have liver stiffness measurement (Fibroscan) and serum marker assays. Fifty-nine patients were enrolled. The performance of each technique for distinguishing F0F1 from F2F3F4 was compared. The area under receiver operating characteristic (AUROC) curves was 0.61, 0.71, 0.79, 0.82, and 0.87 for the aspartate transaminase to platelet ratio index (APRI), Fib-4, Fibrotest, Fibrometre, and Fibroscan. Elastometric thresholds were identified for significant fibrosis and cirrhosis. Combined use of Fibroscan and a serum marker could avoid 80% of biopsies. This study shows that the results of alternative methods concord with those of histology in HBV-infected patients in Burkina Faso. These alternative techniques could help physicians to identify patients requiring treatment.


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  1. Collenberg E, Ouedraogo T, Ganamé J, Fickenscher H, Kynast-Wolf G, Becher H, Kouyaté B, Kräusslich HG, Sangaré L, Tebit DM, , 2006. Seroprevalence of six different viruses among pregnant women and blood donors in rural and urban Burkina Faso: a comparative analysis. J Med Virol 78: 683692.[Crossref] [Google Scholar]
  2. Cadranel JF, Rufat P, Degos F, , 2000. Practices of liver biopsy in France: results of a prospective nationwide survey. For the Group of Epidemiology of the French Association for the Study of the Liver (AFEF). Hepatology 32: 477481.[Crossref] [Google Scholar]
  3. ter Borg F, ten Kate JJ, Cuypers HT, Leentvaar-Kuijpers A, Oosting J Wertheim-van Dillen PM, Honkoop P, Rasch MC, de Man RA, van Hattum J, Chamuleau RA, Tytgat GN, Jones EA, , 2000. A survey of liver pathology in needle biopsies from HbsAg and anti-Hbe positive individuals. J Clin Pathol 53: 541548.[Crossref] [Google Scholar]
  4. Ziol M, Handra-Luca A, Kettaneh A, Christidis C, Mal F, de Lédinghen V, Marcellin P, Dhumeux D, Trinchet JC, Beaugrand M, , 2005. Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with chronic hepatitis C. Hepatology 41: 4854.[Crossref] [Google Scholar]
  5. Ganne-Carrié N, Ziol M, deLedinghen V, Douvin C, Marcellin P, Castera L, Dhumeux D, Trinchet JC, Beaugrand M, , 2006. Accuracy of liver stiffness measurement for the diagnosis of cirrhosis in patients with chronic liver diseases. Hepatology 44: 15111517.[Crossref] [Google Scholar]
  6. Imbert-Bismuth F, Ratziu V, Pieroni L, Charlotte F, Benhamou Y, Poynard T, , 2001. Biochemical markers of liver fibrosis in patients with hepatitis C virus infection. Lancet 357: 10691075.[Crossref] [Google Scholar]
  7. Calès P, Oberti F, Michalak S, Hubert-Fouchard I, Rousselet MC, Konaté A, Gallois Y, Ternisien C, Chevailler A, Lunel F, , 2005. A novel panel of blood markers to assess the degree of liver fibrosis. Hepatology 42: 13731381.[Crossref] [Google Scholar]
  8. Wai CT, Greenson JK, Fontana RJ, Kalbfleisch JD, Marrero JA, Conjeevaram HS, Lok AS, , 2003. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C . Hepatology 38: 518526.[Crossref] [Google Scholar]
  9. Vallet-Pichard A, Mallet V, Pol S, , 2006. FIB-4: a simple, inexpensive and accurate marker of fibrosis in HCV-infected patients. Hepatology 44: 769.[Crossref] [Google Scholar]
  10. 1994. The French METAVIR Cooperative Study Group. Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C. Hepatology 20: 1520.[Crossref] [Google Scholar]
  11. Castera L, Vergniol J, Foucher J, Le Bail B, Chanteloup E, Haaser M, Darriet M, Couzigou P, De Lédinghen V, , 2005. Prospective comparison of transient elastography, fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology 128: 343350.[Crossref] [Google Scholar]
  12. Hui CK, Leung N, Shek TWH, Yao H, Lee WK, Lai JY, Lai ST, Wong WM, Lai LS, Poon RT, Lo CM, Fan ST, Lau GK, , Hong Kong Liver Fibrosis Study Group, 2007. Sustained disease remission after spontaneous HbeAg seroconversion is associtaed with reduction in fibrosis progression in chronic hepatits B Chinese patients. Hepatology 46: 690698.[Crossref] [Google Scholar]
  13. Marcellin P, Ziol M, Bedossa P, Douvin C, Poupon R, de Ledinghen V, Beaugrand M, , 2008. Non-invasive assessment of liver fibrosis by stiffness measurement in patients with chronic hepatitis B. Liver Int 9: 242247.[Crossref] [Google Scholar]

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  • Received : 15 Feb 2009
  • Accepted : 16 Nov 2009
  • Published online : 05 Mar 2010

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