J Korean Med Sci.  2014 Apr;29(4):570-575. 10.3346/jkms.2014.29.4.570.

Assessment of Hepatic Fibrosis Regression by Transient Elastography in Patients with Chronic Hepatitis B Treated with Oral Antiviral Agents

• Kim JK
• Ma DW
• Lee KS
• Paik YH

• KMID: 1774464
• DOI: http://doi.org/10.3346/jkms.2014.29.4.570

Abstract

Transient elastography (TE) has been used as a non-invasive method for liver stiffness measurement (LSM) in patients with chronic liver disease. This study was performed to assess the change of LSM by TE and to assess its clinical usefulness during long-term oral antiviral therapy in patients with chronic hepatitis B (CHB). We retrospectively reviewed 83 CHB patients. The mean interval between two LSM was 411.5 +/- 149.5 days. Initial and follow-up LSM was 16.15 +/- 12.41 kPa and 11.26 +/- 7.36 kPa, respectively (P < 0.001). The degree of regression of liver stiffness was -2.03 +/- 0.36% per month. The fibrosis stage classified by LSM value improved in 37 (44.6%) patients during oral antiviral therapy. Of the 30 (36.1%) patients with LSM > or = 14.1 kPa (cirrhosis) at 1st LSM, 12 (40%) proved to no longer have cirrhosis (> or = 1 decrease in fibrosis stage) at 2nd LSM. LSM significantly decreased in both baseline high (> upper limit of normal [ULN] x 2) and low (< or = ULN x 2) alanine aminotransferase groups during antiviral therapy (P < 0.001; P = 0.001, respectively). Long-term oral antiviral therapy resulted in the improvement of liver stiffness in a substantial portion of patients with CHB. TE may be used a useful clinical tool to assess disease progression in CHB patients.

Keyword

Elasticity Imaging Techniques; Liver Cirrhosis; Hepatitis B, Chronic; Liver Stiffness; Oral Antiviral Agents

MeSH Terms

Administration, Oral
Adult
Aged
Alanine Transaminase/blood
Antiviral Agents/*therapeutic use
Elasticity Imaging Techniques
Female
Hepatitis B, Chronic/*drug therapy
Humans
Liver/ultrasonography
Liver Cirrhosis/*ultrasonography
Male
Middle Aged
Retrospective Studies
Severity of Illness Index
Antiviral Agents
Alanine Transaminase

Figure

• 

  Fig. 1 The difference of liver stiffness values between the first and the second measurement using transient elastography (Fibroscan®) by the type of antiviral agents. The differences of two LSM values were all negative values regardless of antiviral agents. However, there was no significant difference according to the kind of antiviral agents (P = 0.625) or lamivudine resistance (P = 0.078).

• 

  Fig. 2 Changes of the proportion of the patients grouped by the fibrosis stage between two liver stiffness measurements during oral antiviral therapy. The patients' initial fibrosis stages were 16 (19.3%) in F0-1, 15 (18.1%) in F2, 22 (26.5%) in F3 and 30 (36.1%) in F4, respectively. After antiviral therapy, the patients' fibrosis stages were 42 (50.6%) in F0-1, 6 (7.2%) in F2, 12 (14.5%) in F3 and 23 (27.7%) in F4, respectively.

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