Hepatology International

, Volume 4, Issue 4, pp 673–680 | Cite as

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

  • Seung Up Kim
  • Jun Yong Park
  • Do Young Kim
  • Sang Hoon Ahn
  • Eun Hee Choi
  • Jae Yeon Seok
  • Jung Min Lee
  • Young Nyun Park
  • Chae Yoon Chon
  • Kwang-Hyub Han
Original Article



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.


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.


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).


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.


Alanine aminotransferase Chronic hepatitis B Liver fibrosis Liver stiffness measurement Nucleos(t)ide analog Transient elastography 



Liver biopsy


Hepatitis B virus


Hepatitis C virus


Chronic hepatitis B


Chronic hepatitis C


Chronic liver disease


Liver stiffness measurement


Alanine aminotransferase


Aspartate aminotransferase


Upper limit of normal


Hepatitis B surface antigen


Hepatitis B e antigen




Interquartile range


Age–platelet count index


Aspartate aminotransferase to platelet ratio index


Age–spleen–platelet ratio index


Sustained viral response



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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Copyright information

© Asian Pacific Association for the Study of the Liver 2010

Authors and Affiliations

  • Seung Up Kim
    • 1
  • Jun Yong Park
    • 1
    • 2
    • 5
  • Do Young Kim
    • 1
    • 2
    • 5
  • Sang Hoon Ahn
    • 1
    • 2
    • 5
  • Eun Hee Choi
    • 3
  • Jae Yeon Seok
    • 4
  • Jung Min Lee
    • 1
  • Young Nyun Park
    • 4
    • 5
  • Chae Yoon Chon
    • 1
    • 2
    • 5
  • Kwang-Hyub Han
    • 1
    • 2
    • 5
  1. 1.Department of Internal MedicineYonsei University College of MedicineSeoulKorea
  2. 2.Institute of GastroenterologyYonsei University College of MedicineSeoulKorea
  3. 3.Department of BiostatisticsYonsei University College of MedicineSeoulKorea
  4. 4.Department of PathologyYonsei University College of MedicineSeoulKorea
  5. 5.Liver Cirrhosis Clinical Research CenterSeoulKorea

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