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These techniques rely on two distinct but complementary approaches: a \u2018biological\u2019 approach, based on the quantification of biomarkers of fibrosis in serum, and a \u2018physical\u2019 approach, based on the measurement of liver stiffness using elastography\u2010based technologies. Advantages of serum biomarkers include their high applicability (&gt;95%) and good reproducibility. However, as none are liver specific their results can be influenced by comorbid conditions (risk of false positive results with FibroTest<jats:sup>\u00ae<\/jats:sup> in patients with Gilbert's syndrome or with <jats:styled-content style=\"fixed-case\">APRI<\/jats:styled-content> in case of acute hepatitis). Transient elastograpy has the advantages of being a user's friendly procedure that can be performed at the bedside or in an outpatient clinic with high performance for detecting cirrhosis. However, its applicability is lower (80%) than that of serum biomarker (particularly in case of ascites, obesity and limited operator experience) with the risk of false positive results in case of <jats:styled-content style=\"fixed-case\">ALT<\/jats:styled-content> flares. Although these non\u2010invasive methods were initially developed and validated in patients with chronic hepatitis C, they are now increasingly used in patients with hepatitis B, reducing the need for liver biopsy.<\/jats:p>","DOI":"10.1111\/liv.12393","type":"journal-article","created":{"date-parts":[[2013,12,23]],"date-time":"2013-12-23T07:49:39Z","timestamp":1387784979000},"page":"91-96","source":"Crossref","is-referenced-by-count":50,"title":["Hepatitis B: are non\u2010invasive markers of liver fibrosis reliable?"],"prefix":"10.1111","volume":"34","author":[{"given":"Laurent","family":"Castera","sequence":"first","affiliation":[{"name":"Service d'H\u00e9patologie H\u00f4pital Beaujon Assistance Publique\u2010H\u00f4pitaux de Paris INSERM U773 CRB 3 Universit\u00e9 Denis Diderot, Paris\u20107 Clichy 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