| Title: |
Systematic review and individual-patient-data meta-analysis of non-invasive fibrosis markers for chronic hepatitis B in Africa |
| Authors: |
Johannessen, A; Stockdale, AJ; Henrion, MYR; Okeke, E; Seydi, M; Wandeler, G; Sonderup, M; Spearman, CW; Vinikoor, M; Sinkala, E; Desalegn, H; Fall, F; Riches, N; Davwar, P; Duguru, M; Maponga, T; Taljaard, J; Matthews, PC; Andersson, M; Mboup, S; Sombie, R; Shimakawa, Y; Lemoine, M |
| Source: |
Nature Communications , 14 , Article 45. (2023) |
| Publisher Information: |
Springer Science and Business Media LLC |
| Publication Year: |
2023 |
| Collection: |
University College London: UCL Discovery |
| Subject Terms: |
Humans; Hepatitis B; Chronic; Bayes Theorem; ROC Curve; Platelet Count; Aspartate Aminotransferases; Fibrosis; Liver Cirrhosis; Africa; Biomarkers |
| Description: |
In sub-Saharan Africa, simple biomarkers of liver fibrosis are needed to scale-up hepatitis B treatment. We conducted an individual participant data meta-analysis of 3,548 chronic hepatitis B patients living in eight sub-Saharan African countries to assess the World Health Organization-recommended aspartate aminotransferase-to-platelet ratio index and two other fibrosis biomarkers using a Bayesian bivariate model. Transient elastography was used as a reference test with liver stiffness measurement thresholds at 7.9 and 12.2kPa indicating significant fibrosis and cirrhosis, respectively. At the World Health Organization-recommended cirrhosis threshold (>2.0), aspartate aminotransferase-to-platelet ratio index had sensitivity (95% credible interval) of only 16.5% (12.5–20.5). We identified an optimised aspartate aminotransferase-to-platelet ratio index rule-in threshold (>0.65) for liver stiffness measurement >12.2kPa with sensitivity and specificity of 56.2% (50.5–62.2) and 90.0% (89.0–91.0), and an optimised rule-out threshold ( |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10163755/ |
| Availability: |
https://discovery.ucl.ac.uk/id/eprint/10163755/1/s41467-022-35729-w.pdf; https://discovery.ucl.ac.uk/id/eprint/10163755/ |
| Rights: |
open |
| Accession Number: |
edsbas.26280F |
| Database: |
BASE |