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

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.

Keywords

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

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

Notes

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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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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