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Non-invasive assessment of changes in liver fibrosis via liver stiffness measurement in patients with chronic hepatitis B: impact of antiviral treatment on fibrosis regression

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Abstract

Background

Liver stiffness measurement (LSM) can assess liver fibrosis in patients with chronic hepatitis B (CHB). We evaluated whether LSM can be used to assess changes in liver fibrosis during antiviral treatment using nucleos(t)ide analogs in patients with CHB.

Methods

We recruited 41 patients with CHB who had significant liver fibrosis, normal or slightly elevated serum alanine aminotransferase (ALT) levels (≤2 × upper limit of normal), and detectable serum hepatitis B virus DNA before antiviral treatment. Patients in Group 1 (n = 23) and Group 2 (n = 18) underwent follow-up LSM after antiviral treatment for 1 and 2 years, respectively.

Results

The mean age, ALT and LSM value of all patients (34 men and 7 women) before antiviral treatment were 46.6 ± 9.5 years, 40.6 ± 17.2 IU/L and 12.9 ± 8.6 kPa, respectively. Hepatitis B e antigen (HBeAg) was detected in 31 patients (75.6%). Fibrosis stage was F2 in 12 (29.3%), F3 in 6 (14.6%) and F4 in 23 (56.1%) patients. After antiviral treatment, LSM values and DNA positivity decreased significantly as compared to baseline (P = 0.018 and P < 0.001 in Group 1; P = 0.017 and P < 0.001 in Group 2, respectively), whereas ALT levels were unchanged (P = 0.063 in Group 1; P = 0.082 in Group 2).

Conclusions

Our preliminary data suggest that LSM can be used to assess liver fibrosis regression after antiviral treatment using nucleos(t)ide analogs in patients with CHB.

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Abbreviations

LB:

Liver biopsy

HBV:

Hepatitis B virus

HCV:

Hepatitis C virus

CHB:

Chronic hepatitis B

CHC:

Chronic hepatitis C

CLD:

Chronic liver disease

LSM:

Liver stiffness measurement

ALT:

Alanine aminotransferase

AST:

Aspartate aminotransferase

ULN:

Upper limit of normal

HBsAg:

Hepatitis B surface antigen

HBeAg:

Hepatitis B e antigen

kPa:

Kilopascals

IQR:

Interquartile range

API:

Age–platelet count index

APRI:

Aspartate aminotransferase to platelet ratio index

ASPRI:

Age–spleen–platelet ratio index

SVR:

Sustained viral response

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Acknowledgements

This study was supported by the Grant of the Good Health R&D Project from the Ministry of Health, Welfare and Family Affairs, Republic of Korea (A050021), and in part by Brain Korea 21 Project for Medical Science. The authors wish to thank Joon Seong Kim, Ji Won Kim and Jeong Min Cho for their critical comments and support.

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Authors and Affiliations

  1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

    Seung Up Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Jung Min Lee, Chae Yoon Chon & Kwang-Hyub Han

  2. Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea

    Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Chae Yoon Chon & Kwang-Hyub Han

  3. Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea

    Eun Hee Choi

  4. Department of Pathology, Yonsei University College of Medicine, Seoul, Korea

    Jae Yeon Seok & Young Nyun Park

  5. Liver Cirrhosis Clinical Research Center, Seoul, Korea

    Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Young Nyun Park, Chae Yoon Chon & Kwang-Hyub Han

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  1. Seung Up Kim
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Correspondence to Jun Yong Park.

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Kim, S.U., Park, J.Y., Kim, D.Y. et al. Non-invasive assessment of changes in liver fibrosis via liver stiffness measurement in patients with chronic hepatitis B: impact of antiviral treatment on fibrosis regression. Hepatol Int 4, 673–680 (2010). https://doi.org/10.1007/s12072-010-9201-7

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  • DOI: https://doi.org/10.1007/s12072-010-9201-7

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