Systematic review and individual-patient-data meta-analysis of non-invasive fibrosis markers for chronic hepatitis B in Africa.
Systematic review and individual-patient-data meta-analysis of non-invasive fibrosis markers for chronic hepatitis B in Africa.
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DOI：
10.1038/s41467-022-35729-w
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发表时间：
2023-01-03
影响因子：
16.6
通讯作者：
Lemoine, Maud
中科院分区：
文献类型：
--
作者：
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;Sombie, Roger;Shimakawa, Yusuke;Lemoine, Maud
在撒哈拉以南非洲，需要简单的肝纤维化生物标志物来扩大B型肝炎的治疗。我们对生活在8个撒哈拉以南非洲国家的3，548名慢性B型肝炎患者进行了个体参与者数据荟萃分析，以评估世界卫生组织推荐的天冬氨酸转氨酶与血小板比率指数和其他两种纤维化生物标志物，使用贝叶斯双变量模型。瞬时弹性成像被用作参考测试，肝脏硬度测量阈值分别为7.9和12.2kPa，表明显著的纤维化和肝硬化。在世界卫生组织推荐的肝硬化阈值（>2.0）下，门冬氨酸氨基转移酶与血小板比率指数的敏感性（95%可信区间）仅为16.5%（12.5-20.5）。我们确定了优化的门冬氨酸氨基转移酶与血小板比率指数纳入阈值肝硬度>12.2kPa时，敏感性和特异性分别为56.2%和0.65（50.5-62.2）和90.0%（89.0-91.0），最佳排除阈值（<0.36），敏感性和特异性分别为80.6%（76.1-85.1）和64.3%（62.8-65.8）。在这里，我们表明，世界卫生组织推荐的天门冬氨酸氨基转移酶与血小板比率指数阈值在撒哈拉以南非洲是不适当的高，在这种情况下，改进的规则和排除阈值可以优化治疗建议。作者进行了一项系统性综述和荟萃分析，以评价纤维化生物标志物在撒哈拉以南非洲慢性B型肝炎病毒感染患者中诊断纤维化和肝硬化的性能。
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 (<0.36) with sensitivity and specificity of 80.6% (76.1–85.1) and 64.3% (62.8–65.8). Here we show that the World Health Organization-recommended aspartate aminotransferase-to-platelet ratio index threshold is inappropriately high in sub-Saharan Africa; improved rule-in and rule-out thresholds can optimise treatment recommendations in this setting. Authors carry out a systematic review and meta-analysis to evaluate the performance of fibrosis biomarkers for the diagnosis of fibrosis and cirrhosis in patients with chronic hepatitis B virus infection living in sub-Saharan Africa.
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影响因子：
25.7
作者：
Aberra, Hanna;Desalegn, Hailemichael;Johannessen, Asgeir
通讯作者：
Johannessen, Asgeir
影响因子：
2.4
作者：
Desalegn, Hailemichael;Aberra, Hanna;Johannessen, Asgeir
通讯作者：
Johannessen, Asgeir
DOI：
10.1111/j.1530-0277.2010.01374.x
发表时间：
2011-03-01
影响因子：
3.2
作者：
Gelsi, Eve;Dainese, Raphaella;Tran, Albert
通讯作者：
Tran, Albert
DOI：
10.1093/trstmh/trx077
发表时间：
2017-09-01
影响因子：
2.2
作者：
Nsokolo B;Kanunga A;Sinkala E;Zyambo K;Kumwenda D;Chama D;Muyinda G;Vinikoor M;Ijaz S;Tedder R;Elmdaah AKA;Jones M;Chiluba C;Mudenda V;Goldin RD;Foster G;Kelly P
通讯作者：
Kelly P
影响因子：
7.8
作者：
Johannessen A;Mekasha B;Desalegn H;Aberra H;Stene-Johansen K;Berhe N
通讯作者：
Berhe N