{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:44:55Z","timestamp":1791927895686,"version":"4.3.4"},"reference-count":79,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T00:00:00Z","timestamp":1707696000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The aim of this review is to provide updated information on the clinical use of non-invasive serum and imaging-based tests for fibrosis assessment in chronic hepatitis B (CHB) virus infection. In recent years, non-invasive tests (NIT) have been increasingly used to determine eligibility for treatment. Liver biopsy is still considered the gold standard for assessing inflammatory activity and fibrosis staging, but it is an invasive procedure with inherent limitations. Simple serum markers such as APRI and FIB-4 are limited by indeterminate results but remain useful initial tests for fibrosis severity if imaging elastography is not available. Point-of-care US-based elastography techniques, such as vibration-controlled transient elastography or 2D shear wave elastography, are increasingly available and have better accuracy than simple serum tests for advanced fibrosis or cirrhosis, although stiffness cut-offs are variable based on E-antigen status and inflammatory activity. Current NITs have poor diagnostic performance for following changes in fibrosis with antiviral therapy. However, NITs may have greater clinical utility for determining prognosis in patients with CHB that have advanced disease, especially for the development of hepatocellular carcinoma and\/or liver decompensation. Algorithms combining serum and imaging NITs appear promising for advanced fibrosis and prognostic risk stratification.<\/jats:p>","DOI":"10.3390\/jcm13041046","type":"journal-article","created":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T03:50:27Z","timestamp":1707709827000},"page":"1046","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Non-Invasive Assessment of Liver Fibrosis in Hepatitis B Patients"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8506-8447","authenticated-orcid":false,"given":"Chinmay","family":"Bera","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, University Health Network Toronto, Toronto General Hospital, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nashla","family":"Hamdan-Perez","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, University Health Network Toronto, Toronto General Hospital, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keyur","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, University Health Network Toronto, Toronto General Hospital, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,12]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2021). Global Progress Report on HIV, Viral Hepatitis and Sexually Transmitted Infections, World Health Organization."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1056\/NEJMra031087","article-title":"Hepatitis B virus infection--natural history and clinical consequences","volume":"350","author":"Ganem","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1038\/s41575-023-00760-9","article-title":"Global burden of hepatitis B virus: Current status, missed opportunities and a call for action","volume":"20","author":"Hsu","year":"2023","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1016\/S2468-1253(22)00124-8","article-title":"Global, regional, and national burden of hepatitis B, 1990\u20132019: A systematic analysis for the Global Burden of Disease Study 2019","volume":"7","author":"Sheena","year":"2022","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver (2017). EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J. Hepatol., 67, 370\u2013398.","DOI":"10.1016\/j.jhep.2017.03.021"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1053\/j.gastro.2008.02.075","article-title":"Virologic and Histologic Features of Chronic Hepatitis B Virus-Infected Asymptomatic Patients With Persistently Normal ALT","volume":"134","author":"Kumar","year":"2008","journal-title":"Gastroenterology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"423","DOI":"10.3748\/wjg.15.423","article-title":"DNA-guided hepatitis B treatment, viral load is essential, but not sufficient","volume":"15","year":"2009","journal-title":"World J. Gastroenterol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"100067","DOI":"10.1016\/j.jhepr.2020.100067","article-title":"Limitations of non-invasive tests for assessment of liver fibrosis","volume":"2","author":"Patel","year":"2020","journal-title":"JHEP Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.jhep.2021.10.008","article-title":"Reply to: Correspondence on \u201cEASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis\u20142021 update\u201d","volume":"76","author":"Berzigotti","year":"2022","journal-title":"J. Hepatol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver, and Clinical Practice Guideline Panel (2021). EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis\u20142021 update. J. Hepatol., 75, 659\u2013689.","DOI":"10.1016\/j.jhep.2021.05.025"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Xu, X.-Y., Kong, H., Song, R.-X., Zhai, Y.-H., Wu, X.-F., Ai, W.-S., and Liu, H.-B. (2014). The Effectiveness of Noninvasive Biomarkers to Predict Hepatitis B-Related Significant Fibrosis and Cirrhosis: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0100182"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1002\/hep.27382","article-title":"Comparison of diagnostic accuracy of aspartate aminotransferase to platelet ratio index and fibrosis-4 index for detecting liver fibrosis in adult patients with chronic hepatitis B virus infection: A systemic review and meta-analysis","volume":"61","author":"Xiao","year":"2015","journal-title":"Hepatology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1002\/hep.21178","article-title":"Development of a simple noninvasive index to predict significant fibrosis in patients with HIV\/HCV coinfection","volume":"43","author":"Sterling","year":"2006","journal-title":"Hepatology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1097\/MEG.0b013e32835cb5dd","article-title":"Evaluation of seven noninvasive models in staging liver fibrosis in patients with chronic hepatitis B virus infection","volume":"25","author":"Ma","year":"2013","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Li, Y., Chen, Y., and Zhao, Y. (2014). The diagnostic value of the FIB-4 index for staging hepatitis B-related fibrosis: A meta-analysis. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0105728"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/S2468-1253(19)30087-1","article-title":"Optimisation of the use of APRI and FIB-4 to rule out cirrhosis in patients with chronic hepatitis B: Results from the SONIC-B study","volume":"4","author":"Sonneveld","year":"2019","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1111\/j.1365-2036.2007.03378.x","article-title":"Relationship between the Fibrotest and portal hypertension in patients with liver disease","volume":"26","author":"Thabut","year":"2007","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s11901-011-0096-0","article-title":"Noninvasive Markers of Hepatic Fibrosis in Chronic Hepatitis B","volume":"10","author":"Poynard","year":"2011","journal-title":"Curr. Hepat. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Poynard, T., Morra, R., Halfon, P., Castera, L., Ratziu, V., Imbert-Bismut, F., Naveau, S., Thabut, D., Lebrec, D., and Zoulim, F. (2007). Meta-analyses of FibroTest diagnostic value in chronic liver disease. BMC Gastroenterol., 7.","DOI":"10.1186\/1471-230X-7-40"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1053\/jhep.2002.36128","article-title":"Identification of chronic hepatitis C patients without hepatic fibrosis by a simple predictive model: Identification of chronic hepatitis C patients without hepatic fibrosis by a simple predictive model","volume":"36","author":"Forns","year":"2002","journal-title":"Hepatology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1097\/MEG.0b013e32835fd699","article-title":"APRI, the FIB-4 score, and Forn\u2019s index have noninvasive diagnostic value for liver fibrosis in patients with chronic hepatitis B","volume":"25","author":"Ucar","year":"2013","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1111\/j.1572-0241.2005.41289.x","article-title":"Identification of chronic hepatitis B patients without significant liver fibrosis by a simple noninvasive predictive model","volume":"100","author":"Hui","year":"2005","journal-title":"Am. J. Gastroenterol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.jhep.2014.02.029","article-title":"Prospective evaluation of FibroTest\u00ae, FibroMeter\u00ae, and HepaScore\u00ae for staging liver fibrosis in chronic hepatitis B: Comparison with hepatitis C","volume":"61","author":"Leroy","year":"2014","journal-title":"J. Hepatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1002\/hep.20960","article-title":"Prediction of significant fibrosis in HBeAg-positive patients with chronic hepatitis B by a noninvasive model","volume":"42","author":"Zeng","year":"2005","journal-title":"Hepatology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/S1665-2681(19)31025-7","article-title":"Serum N-glycomic markers in combination with panels improves the diagnosis of chronic hepatitis B","volume":"11","author":"Qu","year":"2012","journal-title":"Ann. Hepatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1111\/1751-2980.13140","article-title":"Diagnostic accuracy of mac-2-binding protein glycosylation isomer for diagnosing hepatitis B-related fibrosis: A meta-analysis","volume":"23","author":"Lian","year":"2022","journal-title":"J. Dig. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"605","DOI":"10.3350\/cmh.2022.0342","article-title":"Development of hepatocellular carcinoma in treated and untreated patients with chronic hepatitis B virus infection","volume":"29","author":"Lin","year":"2023","journal-title":"Clin. Mol. Hepatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"4407","DOI":"10.1007\/s10620-023-08143-5","article-title":"Evaluating M2BPGi as a Marker for Liver Fibrosis in Patients with Chronic Hepatitis B","volume":"68","author":"Bui","year":"2023","journal-title":"Dig. Dis. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.3748\/wjg.v26.i11.1113","article-title":"Circulating microRNAs as non-invasive biomarkers for hepatitis B virus liver fibrosis","volume":"26","author":"Iacob","year":"2020","journal-title":"World J. Gastroenterol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"860","DOI":"10.5009\/gnl16560","article-title":"Serum MicroRNA Levels as a Noninvasive Diagnostic Biomarker for the Early Diagnosis of Hepatitis B Virus-Related Liver Fibrosis","volume":"11","author":"Bao","year":"2017","journal-title":"Gut Liver"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1111\/j.1478-3231.2011.02491.x","article-title":"Evaluation of normal or minimally elevated alanine transaminase, age and DNA level in predicting liver histological changes in chronic hepatitis B","volume":"31","author":"Alam","year":"2011","journal-title":"Liver Int."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"247","DOI":"10.14218\/JCTH.2021.00151","article-title":"Gamma-glutamyl Transpeptidase to Platelet Ratio Predicts Liver Injury in Hepatitis B e Antigen-negative Chronic Hepatitis B Patients With Normal Alanine Aminotransferase","volume":"10","author":"Zhao","year":"2022","journal-title":"J. Clin. Transl. Hepatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1825","DOI":"10.1016\/j.ultrasmedbio.2010.07.005","article-title":"Controlled attenuation parameter (CAP): A novel VCTE\u2122 guided ultrasonic attenuation measurement for the evaluation of hepatic steatosis: Preliminary study and validation in a cohort of patients with chronic liver disease from various causes","volume":"36","author":"Sasso","year":"2010","journal-title":"Ultrasound Med. Biol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.1016\/j.ultrasmedbio.2003.07.001","article-title":"Transient elastography: A new noninvasive method for assessment of hepatic fibrosis","volume":"29","author":"Sandrin","year":"2003","journal-title":"Ultrasound Med. Biol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1016\/j.jhep.2008.02.008","article-title":"Non-invasive evaluation of liver fibrosis using transient elastography","volume":"48","author":"Castera","year":"2008","journal-title":"J. Hepatol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1136\/gut.2006.111302","article-title":"Reproducibility of transient elastography in the evaluation of liver fibrosis in patients with chronic liver disease","volume":"56","author":"Fraquelli","year":"2007","journal-title":"Gut"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"6154","DOI":"10.3748\/wjg.14.6154","article-title":"Liver stiffness in the hepatitis B virus carrier: A non-invasive marker of liver disease influenced by the pattern of transaminases","volume":"14","author":"Oliveri","year":"2008","journal-title":"World J. Gastroenterol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1111\/j.1365-2893.2009.01120.x","article-title":"An evaluation of transient elastography in the discrimination of HBeAg-negative disease from inactive hepatitis B carriers","volume":"16","author":"Maimone","year":"2009","journal-title":"J. Viral Hepat."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"384","DOI":"10.3350\/cmh.2018.0004","article-title":"Characterization and evaluation of liver fibrosis grade in patients with chronic hepatitis B virus infection and normal transaminases","volume":"24","author":"Cristina","year":"2018","journal-title":"Clin. Mol. Hepatol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1111\/jvh.12176","article-title":"The usefulness of transient elastography in the assessment of patients with HBeAg-negative chronic hepatitis B virus infection","volume":"21","author":"Papatheodoridis","year":"2014","journal-title":"J. Viral Hepat."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1842","DOI":"10.1111\/jgh.12327","article-title":"Liver fibrosis progression is uncommon in patients with inactive chronic hepatitis B: A prospective cohort study with paired transient elastography examination","volume":"28","author":"Wong","year":"2013","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Delle Monache, M., Petrelli, A., Rossi, A., Cecere, R., Mirisola, C., Costanzo, G., Francia, C., Cerini, F., Cavani, A., and Nosotti, L. (2021). Noninvasive Evaluation of Liver Fibrosis in a Sample of Putative Inactive HBV Carriers in Rome, Italy. Can. J. Infect. Dis. Med. Microbiol., 2021.","DOI":"10.1155\/2021\/3068690"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1002\/cld.728","article-title":"Update on Prevention, Diagnosis, and Treatment of Chronic Hepatitis B: AASLD 2018 Hepatitis B Guidance","volume":"12","author":"Terrault","year":"2018","journal-title":"Clin. Liver Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"641","DOI":"10.3748\/wjg.v27.i7.641","article-title":"Effect of liver inflammation on accuracy of FibroScan device in assessing liver fibrosis stage in patients with chronic hepatitis B virus infection","volume":"27","author":"Huang","year":"2021","journal-title":"World J. Gastroenterol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver, and Asociacion Latinoamericana para el Estudio del Higado (2015). EASL-ALEH Clinical Practice Guidelines: Non-invasive tests for evaluation of liver disease severity and prognosis. J. Hepatol., 63, 237\u2013264.","DOI":"10.1016\/j.jhep.2015.04.006"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Qi, X., An, M., Wu, T., Jiang, D., Peng, M., Wang, W., Wang, J., Zhang, C., and the CHESS Study Group (2018). Transient Elastography for Significant Liver Fibrosis and Cirrhosis in Chronic Hepatitis B: A Meta-Analysis. Can. J. Gastroenterol. Hepatol., 2018.","DOI":"10.1155\/2018\/3406789"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1111\/apt.13488","article-title":"Systematic review with meta-analysis: The diagnostic accuracy of transient elastography for the staging of liver fibrosis in patients with chronic hepatitis B","volume":"43","author":"Li","year":"2016","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1007\/s12072-015-9643-z","article-title":"Performance of transient elastography assessing fibrosis of single hepatitis B virus infection: A systematic review and meta-analysis of a diagnostic test","volume":"9","author":"Xu","year":"2015","journal-title":"Hepatol. Int."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Chon, Y.E., Choi, E.H., Song, K.J., Park, J.Y., Kim, D.Y., Han, K.H., Chon, C.Y., Ahn, S.H., and Kim, S.U. (2012). Performance of transient elastography for the staging of liver fibrosis in patients with chronic hepatitis B: A meta-analysis. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0044930"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1111\/j.1478-3231.2011.02660.x","article-title":"Direct comparison of diagnostic performance of transient elastography in patients with chronic hepatitis B and chronic hepatitis C","volume":"32","author":"Cardoso","year":"2012","journal-title":"Liver Int."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1055\/s-0042-1755251","article-title":"Diagnostic Performance of Acoustic Radiation Force Impulse Imaging in Evaluating Liver Fibrosis in Patients with Chronic Hepatitis B Infection: A Cross-Sectional Study","volume":"32","author":"Bui","year":"2022","journal-title":"Indian. J. Radiol. Imaging"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"23","DOI":"10.11152\/mu-942","article-title":"Acoustic Radiation Force Impulse (ARFI) Elastography for non-invasive evaluation of hepatic fibrosis in chronic hepatitis B and C patients: A systematic review and meta-analysis","volume":"19","author":"Hu","year":"2017","journal-title":"Med. Ultrason."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1148\/radiol.2018171116","article-title":"Acoustic Radiation Force Impulse US Imaging: Liver Stiffness in Patients with Chronic Hepatitis B with and without Antiviral Therapy","volume":"288","author":"Su","year":"2018","journal-title":"Radiology"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"3028","DOI":"10.1007\/s00261-022-03597-z","article-title":"Magnetic resonance elastography: From invention to standard of care","volume":"47","author":"Ehman","year":"2022","journal-title":"Abdom. Radiol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1148\/radiol.11101942","article-title":"Early detection of nonalcoholic steatohepatitis in patients with nonalcoholic fatty liver disease by using MR elastography","volume":"259","author":"Chen","year":"2011","journal-title":"Radiology"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1007\/s00330-013-2978-8","article-title":"Magnetic resonance elastography for the detection and staging of liver fibrosis in chronic hepatitis B","volume":"24","author":"Venkatesh","year":"2014","journal-title":"Eur. Radiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"401","DOI":"10.5009\/gnl16079","article-title":"Magnetic Resonance Elastography and Diffusion Weighted Imaging in the Evaluation of Hepatic Fibrosis in Chronic Hepatitis B","volume":"11","author":"Hennedige","year":"2017","journal-title":"Gut Liver"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"211","DOI":"10.2463\/mrms.2014-0150","article-title":"Validity and Reliability of Magnetic Resonance Elastography for Staging Hepatic Fibrosis in Patients with Chronic Hepatitis B","volume":"14","author":"Ichikawa","year":"2015","journal-title":"Magn. Reson. Med. Sci."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1016\/j.jhep.2014.12.007","article-title":"Real-time shear-wave elastography: Applicability, reliability and accuracy for clinically significant portal hypertension","volume":"62","author":"Procopet","year":"2015","journal-title":"J. Hepatol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1002\/hep.29179","article-title":"Assessment of biopsy-proven liver fibrosis by two-dimensional shear wave elastography: An individual patient data-based meta-analysis","volume":"67","author":"Herrmann","year":"2018","journal-title":"Hepatology"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1016\/j.ultrasmedbio.2017.03.014","article-title":"Comparison of 2-D Shear Wave Elastography and Transient Elastography for Assessing Liver Fibrosis in Chronic Hepatitis B","volume":"43","author":"Zeng","year":"2017","journal-title":"Ultrasound Med. Biol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1080\/17474124.2021.1880894","article-title":"Comparison of two-dimensional shear wave elastography, magnetic resonance elastography, and three serum markers for diagnosing fibrosis in patients with chronic hepatitis B: A meta-analysis","volume":"15","author":"Dong","year":"2021","journal-title":"Expert. Rev. Gastroenterol. Hepatol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"108839","DOI":"10.1016\/j.ejrad.2020.108839","article-title":"Two-dimensional shear wave elastography for significant liver fibrosis in patients with chronic hepatitis B: A systematic review and meta-analysis","volume":"124","author":"Wei","year":"2020","journal-title":"Eur. J. Radiol."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Fan, R., Li, G., Yu, N., Chang, X., Arshad, T., Liu, W.Y., Chen, Y., Wong, G.L., Jiang, Y., and Liang, X. (2023). aMAP Score and Its Combination With Liver Stiffness Measurement Accurately Assess Liver Fibrosis in Chronic Hepatitis B Patients. Clin. Gastroenterol. Hepatol.","DOI":"10.1016\/j.cgh.2023.03.005"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/j.jhep.2015.11.012","article-title":"Evaluation of APRI and FIB-4 scoring systems for non-invasive assessment of hepatic fibrosis in chronic hepatitis B patients","volume":"64","author":"Kim","year":"2016","journal-title":"J. Hepatol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1002\/jum.14822","article-title":"Dynamic Changes of the Aspartate Aminotransferase-to-Platelet Ratio and Transient Elastography in Predicting a Histologic Response in Patients With Chronic Hepatitis B After Entecavir Treatment","volume":"38","author":"Sun","year":"2019","journal-title":"J. Ultrasound Med."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Cho, H., Lee, Y.B., Ha, Y., Chon, Y.E., Kim, M.N., Lee, J.H., Park, H., Rim, K.S., and Hwang, S.G. (2023). Changes in liver stiffness values assessed using transient elastography in chronic hepatitis B patients treated with tenofovir disoproxil fumarate: A prospective observational study. BMC Gastroenterol., 23.","DOI":"10.1186\/s12876-023-02846-9"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1111\/jgh.14498","article-title":"Declining in liver stiffness cannot indicate fibrosis regression in patients with chronic hepatitis B: A 78-week prospective study","volume":"34","author":"Dong","year":"2019","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1111\/apt.12307","article-title":"Non-invasive tests for fibrosis and liver stiffness predict 5-year survival of patients chronically infected with hepatitis B virus","volume":"37","author":"Vergniol","year":"2013","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1111\/apt.14619","article-title":"Fibrosis-4 index predicts cirrhosis risk and liver-related mortality in 2075 patients with chronic HBV infection","volume":"47","author":"Tseng","year":"2018","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1111\/jvh.13560","article-title":"Risk assessment of hepatocellular carcinoma and liver-related events using ultrasonography and transient elastography in patients with chronic hepatitis B","volume":"28","author":"Yoo","year":"2021","journal-title":"J. Viral Hepat."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1097\/MCG.0b013e31829a7247","article-title":"Risk assessment of liver-related events using transient elastography in patients with chronic hepatitis B receiving entecavir","volume":"48","author":"Kim","year":"2014","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Kim, S.U., Lee, J.H., Kim, D.Y., Ahn, S.H., Jung, K.S., Choi, E.H., Park, Y.N., Han, K.H., Chon, C.Y., and Park, J.Y. (2012). Prediction of liver-related events using fibroscan in chronic hepatitis B patients showing advanced liver fibrosis. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0036676"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1007\/s12072-017-9789-y","article-title":"Subcirrhotic liver stiffness by FibroScan correlates with lower risk of hepatocellular carcinoma in patients with HBV-related cirrhosis","volume":"11","author":"Jeon","year":"2017","journal-title":"Hepatol. Int."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.2147\/JHC.S372571","article-title":"Incidence of Hepatocellular Carcinoma and Decompensated Liver Cirrhosis and Prognostic Accuracy of the PAGE-B HCC Risk Score in a Low Endemic Hepatitis B Virus Infected Population","volume":"9","author":"Bollerup","year":"2022","journal-title":"J. Hepatocell. Carcinoma"},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Lee, J.S., Lee, H.W., Lim, T.S., Shin, H.J., Lee, H.W., Kim, S.U., Park, J.Y., Kim, D.Y., Ahn, S.H., and Kim, B.K. (2021). Novel Liver Stiffness-Based Nomogram for Predicting Hepatocellular Carcinoma Risk in Patients with Chronic Hepatitis B Virus Infection Initiating Antiviral Therapy. Cancers, 13.","DOI":"10.3390\/cancers13235892"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1148\/radiol.2020191481","article-title":"Liver Stiffness Measured with Two-dimensional Shear-Wave Elastography Is Predictive of Liver-related Events in Patients with Chronic Liver Disease Due to Hepatis B Viral Infection","volume":"295","author":"Wu","year":"2020","journal-title":"Radiology"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1148\/radiol.2021204700","article-title":"APS (Age, Platelets, 2D Shear-Wave Elastography) Score Predicts Hepatocellular Carcinoma in Chronic Hepatitis B","volume":"301","author":"Zhang","year":"2021","journal-title":"Radiology"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1111\/liv.14334","article-title":"Clinical utility of hepatocellular carcinoma risk scores in chronic hepatitis B","volume":"40","author":"Voulgaris","year":"2020","journal-title":"Liver Int."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/4\/1046\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:58:49Z","timestamp":1760104729000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/4\/1046"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,12]]},"references-count":79,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["jcm13041046"],"URL":"https:\/\/doi.org\/10.3390\/jcm13041046","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,12]]}}}