Table 2.
Liver fibrosis status and assessment methods used in studies describing HBsAg-positive people
|
Proportion of HBsAg-positive participants with selected stages of liver fibrosis |
Proportion of studies using different methods used to assess liver fibrosis |
|||||||
|---|---|---|---|---|---|---|---|---|
| F2 (n=16)* | F3 (n=16)* | F4 (cirrhosis; n=104)* | Clinical assessment (43 studies) | NIM (102 studies) | Ultrasound (59 studies) | Transient elastography (20 studies) | Biopsy (61 studies) | |
| Year of publication | ||||||||
| 2007–11 (n=50) | 26% (24–27) | 20% (18–21) | 11·0% (10·6–11·4) | 29% (16–41) | 67% (54–79) | 43% (30–57) | 4% (1–13) | 41% (27–54) |
| 2012–18 (n=112) | 18% (16–19) | 16% (15–17) | 8·5% (8·2–8·7) | 25% (18–34) | 61% (52–70) | 33% (25–42) | 15% (10–23) | 36% (27–45) |
| Recruitment setting | ||||||||
| Outpatient clinic (n=54) | 31% (28–34) | 33% (30–35) | 9·5% (9·2–9·9) | 46% (32–59) | 62% (55–80) | 45% (33–58) | 13% (6–21) | 51% (38–65) |
| Inpatients (n=68) | 30% (29–32) | 24% (22–25) | 13·9% (13·5–14·4) | 26% (17–38) | 57% (46–69) | 32% (22–44) | 13% (7–23) | 43% (32–54) |
| Population-based (n=11)† | 1% (<1–2) | 3% (2–4) | 22·0% (20·0–24·0) | 9% (2–38) | 50% (19–81) | 18% (5–46) | 9% (2–38) | 9% (2–38) |
| Community (n=21)‡ | .. | 9% (5–13) | 9·6% (8·9–10·2) | 14% (5–35) | 85% (69–100) | 52% (32–72) | 10% (3–29) | 24% (11–45) |
| Special groups (n=20) | 6% (2–9) | 8% (2–14) | 7·7% (6·9–8·6) | 50% (24–76) | 60% (38–81) | 40% (21–61) | 20% (8–42) | 25% (11–47) |
| WHO region | ||||||||
| Americas n=34) | 5% (2–8) | 6% (2–9) | 7·3% (6·9–7·6) | 41% (26–58) | 74% (59–88) | 44% (29–61) | 6% (2–19) | 68% (51–81) |
| African (n=46) | 12% (10–13) | 15% (13–17) | 8·1% (7·8–8·4) | 30% (17–43) | 57% (43–72) | 30% (18–44) | 21% (12–35) | 45% (31–60) |
| Eastern Mediterranean (n=33) | 15% (11–19) | 4% (2–6) | 12·8% (12·1–13·4) | 30% (17–47) | 63% (47–80) | 39% (25–56) | 12% (5–27) | 51% (35–67) |
| European (n=51) | 37% (33–42) | 18% (14–21) | 14·2% (13·7–14·9) | 35% (22–48) | 54% (40–67) | 33% (21–46) | 10% (4–21) | 54% (40–67) |
| Southeast Asia (n=40) | 5% (2–8) | 6% (2–9) | 15·3% (14·7–15·8) | 37% (22–52) | 63% (49–78) | 41% (27–57) | 5% (2–16) | 60% (44–75) |
| Western Pacific (n=72) | 26% (24–28) | 21% (19–23) | 8·6% (8·2–8·8) | 23% (13–33) | 59% (43–71) | 37% (27–48) | 7% (3–15) | 40% (28–51) |
| Overall | 21% (19–23) | 18% (17–19) | 9·5% (9·3–9·7) | 26% (19–33) | 63% (55–70) | 36% (29–44) | 12% (8–17) | 37% (30–45) |
Data are % (95% CI). NIM=non-invasive methods, include clinical criteria, ultrasound, or transient elastography.
*
Number of studies available that estimated the proportion of people with this specific stage of liver fibrosis. Only a minority of studies reported data on the proportion of persons with F2 and F3 fibrosis.
†
Studies of individuals not seeking care sampled using statistically representative methods.
‡
Studies of individuals not seeking care but recruited without statistically representative methods.