COMPARISON OF IL-34, ELASTOGRAPHY, AND BIOPSY IN THE ASSESSMENT OF LIVER FIBROSIS IN CHRONIC HEPATITIS B Evaluating Non-Invasive and Invasive Methods in Liver Fibrosis
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Keywords
Chronic hepatitis B, fibrosis, liver needle biopsy, shear wave elastography (SWE), IL-34
Abstract
Background: HBV leads to the development of liver fibrosis. Although liver biopsy is considered the gold standard, it is an invasive procedure. This study aimed to compare non-invasive methods, shear wave elastography (SWE) and serum interleukin-34 (IL-34), with liver biopsy pathology results in treatment-naïve CHB patients to assess their reliability in evaluating liver fibrosis.
Material and Methods: Between 2021 and 2022, a total of 392 treatment-naïve patients diagnosed with CHB who presented to the infectious diseases outpatient clinic and were evaluated for liver biopsy indication were initially screened. After applying exclusion criteria, 105 patients were included in this prospective study. To determine liver fibrosis, SWE and serum IL-34 levels were compared simultaneously with liver biopsy pathology findings.
Results: Among the 105 patients included, 58 (55%) were male, and the mean age was 42.97 years. The median IL-34 level was 10.70 pg/mL in patients with fibrosis ≥2, compared to 6.20 pg/mL in those with fibrosis 0–1. IL-34 levels were found to be significantly associated with advanced stages of fibrosis (p<0.001). According to ROC analysis, the optimal cut-off values for predicting fibrosis≥2 were 8.1 pg/mL for IL-34 (AUC=0.955) and 8.18 kPa for SWE (AUC=0.939). Both IL-34 and SWE demonstrated high sensitivity and specificity in predicting advanced fibrosis and higher necroinflammatory activity.
Conclusion: IL-34 and SWE exhibit high diagnostic performance as non-invasive methods for assessing liver fibrosis in CHB patients. The integration of these approaches into clinical practice may significantly reduce the need for biopsy and, due to their repeatability and lower cost, provide substantial advantages in patient management.
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