Elevated liver stiffness without histological evidence of liver fibrosis in rural Ugandans

Liver fibrosis may be assessed noninvasively with transient electrography (TE). Data on the performance of TE for detecting liver fibrosis in sub‐Saharan Africa are limited. We evaluated the diagnostic accuracy of TE by performing liver biopsies on persons with liver fibrosis indicated by TE. We enr...

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Bibliographic Details
Published in:Journal of viral hepatitis 2020-10, Vol.27 (10), p.1022-1031
Main Authors: Tibuakuu, Martin, Jjingo, Caroline, Kirk, Gregory Dale, Thomas, David Lee, Gray, Ronald, Ssempijja, Victor, Nalugoda, Fred, Serwadda, David, Ocama, Ponsiano, Opio, Christopher Kenneth, Kleiner, David Erwin, Quinn, Thomas Charles, Reynolds, Steven James
Format: Article
Language:English
Subjects:
Bile
Biopsy
Discordance
Elasticity Imaging Techniques
Female
Fibrosis
Gender
Herbal medicine
HIV
Human immunodeficiency virus
Humans
Liver
Liver - diagnostic imaging
Liver - pathology
liver biopsy
Liver Cirrhosis - epidemiology
Liver Cirrhosis - pathology
liver disease
Liver diseases
transient electrography
Uganda
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Summary:Liver fibrosis may be assessed noninvasively with transient electrography (TE). Data on the performance of TE for detecting liver fibrosis in sub‐Saharan Africa are limited. We evaluated the diagnostic accuracy of TE by performing liver biopsies on persons with liver fibrosis indicated by TE. We enrolled HIV‐infected and HIV‐uninfected participants with TE scores consistent with at least minimal disease (liver stiffness measurement [LSM]≥7.1 kPa). Biopsies were performed and staged using the Ishak scoring system. A concordant result was defined using accepted thresholds for significant fibrosis by TE (LSM ≥ 9.3 kPa) and liver biopsy (Ishak score ≥ 2). We used modified Poisson regression methods to quantify the univariate and adjusted prevalence risk ratios (PRR) of the association between covariates and the concordance status of TE and liver biopsy in defining the presence of liver fibrosis. Of 131 participants with valid liver biopsy and TE data, only 5 participants (3.8%) had Ishak score ≥ 2 of whom 4 had LSM ≥ 9.3 kPa (sensitivity = 80%); of the 126 (96.2%) with Ishak score 
ISSN:1352-0504
1365-2893
1365-2893
DOI:10.1111/jvh.13320