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Shear wave elastography: How well does it perform in chronic hepatitis D virus infection?
Alexander H Yang1, David Yardeni1, Julian Hercun1
1Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA.
Journal of Viral Hepatitis
|September 5, 2022
Summary
Shear wave elastography (SWE) shows good performance in detecting liver cirrhosis caused by Hepatitis D Virus (HDV), though slightly less accurate than for Hepatitis B (HBV) or C (HCV). This non-invasive method is comparable to Fibroscan® (VCTE) for HDV patients.
Area of Science:
- Hepatology
- Medical Imaging
- Virology
Background:
- Hepatitis delta virus (HDV) infection accelerates liver disease progression to cirrhosis.
- Non-invasive methods for assessing liver fibrosis are crucial for patient management.
- The diagnostic accuracy of Shear Wave Elastography (SWE) for HDV-related fibrosis is not well-established compared to other viral hepatitis.
Purpose of the Study:
- To evaluate the performance of Shear Wave Elastography (SWE) in diagnosing liver cirrhosis in patients with chronic Hepatitis D Virus (HDV) infection.
- To compare the diagnostic accuracy of SWE with other non-invasive markers like Fibroscan® (VCTE), APRI, and FIB-4 in HDV patients.
- To assess SWE's effectiveness in characterizing fibrosis in HDV compared to Hepatitis B (HBV) and Hepatitis C (HCV) infections.
Main Methods:
- A study involving 158 patients with chronic hepatitis (HDV, HBV, HCV) was conducted.
- Cirrhosis was confirmed by histology or clinical data.
- Diagnostic performance was assessed using Area Under the Receiver Operator Characteristics (AUROC) curves, comparing SWE, VCTE, APRI, and FIB-4.
Main Results:
- The Area Under the Receiver Operator Characteristic (AUROC) for SWE in detecting HDV-induced cirrhosis was 0.84, slightly lower than for HBV/HCV (0.88).
- In HDV patients, SWE performance was comparable to VCTE and superior to APRI and FIB-4, particularly in indeterminate zones.
- Non-invasive markers showed slightly less accuracy in HDV compared to HBV and HCV, potentially due to significant hepatic inflammation.
Conclusions:
- Shear Wave Elastography (SWE) is a valuable non-invasive tool for assessing liver fibrosis in Hepatitis D Virus (HDV) infection.
- While SWE's accuracy for HDV is slightly less than for HBV/HCV, it remains a reliable method, comparable to VCTE.
- The findings suggest that hepatic inflammation in HDV may influence the accuracy of non-invasive fibrosis assessment.
