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Systematic review and individual-patient-data meta-analysis of non-invasive fibrosis markers for chronic hepatitis B in Africa

Author

Listed:
  • Asgeir Johannessen

    (Vestfold Hospital
    University of Oslo)

  • Alexander J. Stockdale

    (University of Liverpool
    Malawi-Liverpool-Wellcome Trust Clinical Research Programme)

  • Marc Y. R. Henrion

    (Malawi-Liverpool-Wellcome Trust Clinical Research Programme
    Liverpool School of Tropical Medicine)

  • Edith Okeke

    (University of Jos)

  • Moussa Seydi

    (Centre Hospitalier National Universitaire de Fann)

  • Gilles Wandeler

    (University of Bern)

  • Mark Sonderup

    (University of Cape Town)

  • C. Wendy Spearman

    (University of Cape Town)

  • Michael Vinikoor

    (University of Zambia
    University of Alabama at Birmingham)

  • Edford Sinkala

    (University of Zambia)

  • Hailemichael Desalegn

    (Vestfold Hospital
    St. Paul’s Hospital Millennium Medical College)

  • Fatou Fall

    (Hopital Principal de Dakar)

  • Nicholas Riches

    (Liverpool School of Tropical Medicine)

  • Pantong Davwar

    (University of Jos)

  • Mary Duguru

    (University of Jos)

  • Tongai Maponga

    (Stellenbosch University Faculty of Medicine and Health Sciences)

  • Jantjie Taljaard

    (Tygerberg Hospital and Stellenbosch University)

  • Philippa C. Matthews

    (University of Oxford
    The Francis Crick Institute
    University College London)

  • Monique Andersson

    (Stellenbosch University Faculty of Medicine and Health Sciences
    University of Oxford)

  • Souleyman Mboup

    (de Surveillance Épidémiologique et de Formations (IRESSEF))

  • Roger Sombie

    (Yalgado Ouédraogo University Hospital Center)

  • Yusuke Shimakawa

    (Unité d’Epidémiologie des Maladies Emergentes, Institut Pasteur)

  • Maud Lemoine

    (Imperial College London)

Abstract

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 (

Suggested Citation

  • 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 D, 2023. "Systematic review and individual-patient-data meta-analysis of non-invasive fibrosis markers for chronic hepatitis B in Africa," Nature Communications, Nature, vol. 14(1), pages 1-12, December.
    • Handle: RePEc:nat:natcom:v:14:y:2023:i:1:d:10.1038_s41467-022-35729-w
    DOI: 10.1038/s41467-022-35729-w
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