Systematic review and individual-patient-data meta-analysis of non-invasive fibrosis markers for chronic hepatitis B in Africa
| Autor: | Asgeir Johannessen, Alexander J. Stockdale, Marc Y. R. Henrion, Edith Okeke, Moussa Seydi, Gilles Wandeler, Mark Sonderup, C. Wendy Spearman, Michael Vinikoor, Edford Sinkala, Hailemichael Desalegn, Fatou Fall, Nicholas Riches, Pantong Davwar, Mary Duguru, Tongai Maponga, Jantjie Taljaard, Philippa C. Matthews, Monique Andersson, Souleyman Mboup, Roger Sombie, Yusuke Shimakawa, Maud Lemoine |
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| Rok vydání: | 2023 |
| Předmět: |
Liver Cirrhosis
Multidisciplinary Platelet Count FOS: Clinical medicine Immunology 360 Soziale Probleme Sozialdienste General Physics and Astronomy Bayes Theorem 610 Medicine & health Infectious Disease General Chemistry Fibrosis General Biochemistry Genetics and Molecular Biology Hepatitis B Chronic ROC Curve 360 Social problems & social services Africa Humans Aspartate Aminotransferases 610 Medizin und Gesundheit Genetics & Genomics Biomarkers |
| Zdroj: | Johannessen, Asgeir; Stockdale, Alexander J; Henrion, Marc Y R; Okeke, Edith; Seydi, Moussa; Wandeler, Gilles; Sonderup, Mark; Spearman, C Wendy; Vinikoor, Michael; Sinkala, Edford; Desalegn, Hailemichael; Fall, Fatou; Riches, Nicholas; Davwar, Pantong; Duguru, Mary; Maponga, Tongai; Taljaard, Jantjie; Matthews, Philippa C; Andersson, Monique; Mboup, Souleyman; ... (2023). Systematic review and individual-patient-data meta-analysis of non-invasive fibrosis markers for chronic hepatitis B in Africa. Nature communications, 14(1), p. 45. Nature Publishing Group 10.1038/s41467-022-35729-w |
| DOI: | 10.48350/176793 |
| Popis: | 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 ( |
| Databáze: | OpenAIRE |
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