Comparison of IL-34, Elastography, and Biopsy in the Assessment of Liver Fibrosis in Chronic Hepatitis B.

Background: Hepatitis B virus (HBV) infection leads to liver fibrosis. Although liver biopsy remains the gold standard for diagnosis, its invasive nature limits routine application. Serum interleukin-34 (IL-34), which plays a role in macrophage activation and fibrogenesis, and shear wave elastography (SWE), a non-invasive method for measuring liver stiffness, represent potential diagnostic alternatives. This study compared the accuracy of IL-34 and SWE with liver biopsy findings in treatment-naive patients with chronic hepatitis B (CHB). Material and Methods: Between 2021 and 2022, 392 treatment-naive patients with CHB who were evaluated for liver biopsy were screened, and 105 eligible patients were prospectively enrolled in the study. Liver fibrosis was assessed by concurrently comparing SWE and IL-34 levels with histopathological biopsy findings. Results: Of the 105 included patients (55% male; mean age 42.97 years), median IL-34 levels were significantly higher in those with fibrosis ≥2 than in patients with fibrosis 0-1 (10.70 vs. 6.20 pg/mL, 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. This study is limited by its single-center design and the small number of cases with advanced fibrosis, which may affect its generalizability. Larger multicenter studies are warranted to validate these findings.