Sterling RK, King WC, Wahed AS, et al. - Since noninvasive biomarkers are used increasingly to evaluate fibrosis in chronic liver disease patients, researchers identified the usefulness of dual cutoffs for noninvasive biomarkers to exclude and confirm advanced fibrosis in HBV–HIV co-infected patients receiving combined antiretroviral therapy. The study sample consisted of anti-HIV/HBsAg positive adults from eight clinical sites in the United States and Canada of the Hepatitis B Research Network. Using established methodology, dual cut-offs for three non-invasive biomarkers (APRI, FIB-4 and liver stiffness by vibration-controlled transient elastography [VCTE]) with the best precision to exclude or confirm advanced fibrosis (F ≥ 3) were determined. Investigators found that VCTE cut-offs of ≤ 5.0 kPa (to exclude) and ≥ 8.8 kPa (to confirm) advanced fibrosis had a 92.3% sensitivity and 96.0% specificity, respectively, and accounted for 65.1% of candidates. In HBV/HIV co-infected adults on combined antiretroviral therapy, VCTE is superior to APRI or FIB-4 as a biomarker of advanced fibrosis. About two-thirds of patients could prevent biopsy using VCTE dual cutoffs to determine advanced fibrosis.