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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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.
KeywordsAlanine aminotransferase Chronic hepatitis B Liver fibrosis Liver stiffness measurement Nucleos(t)ide analog Transient elastography
Hepatitis B virus
Hepatitis C virus
Chronic hepatitis B
Chronic hepatitis C
Chronic liver disease
Liver stiffness measurement
Upper limit of normal
Hepatitis B surface antigen
Hepatitis B e antigen
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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