Significant changes in liver stiffness measurements in patients with chronic hepatitis B: 3-year follow-up study

[Guest guest]

J Viral Hepat. 2011 Jul;18(7):e200-5. doi: 10.1111/j.1365-2893.2010.01428.x.

Epub 2011 Jan 7.

Significant changes in liver stiffness measurements in patients with chronic

hepatitis B: 3-year follow-up study.

Fung J, Lai CL, Wong DK, Seto WK, Hung I, Yuen MF.

Source

Department of Medicine, The University of Hong Kong, Queen Hospital, Hong

Kong, China.

Abstract

Summary.  For patients with chronic hepatitis B (CHB) infection, changes in

liver stiffness measurement (LSM) over time are not known. We examined changes

longitudinally in a cohort of patients. Four hundred and twenty-six patients

with CHB underwent transient elastography. Patients were followed regularly, and

repeat elastography was performed at 3 years. Hepatitis serology, viral load

and routine liver biochemistry were monitored. Of the 426 patients, 38 (9%) were

hepatitis B e-antigen (HBeAg)-positive, 293 (69%) were HBeAg-negative and 95

(22%) were patients with prior hepatitis B surface antigen (HBsAg)

seroclearance. A total of 110 patients received oral antiviral therapy. There

was a significant decline of LSMs at the follow-up measurement compared to

baseline (6.1 vs 7.8 kPa respectively, P = 0.002) in treated patients who

had elevated alanine aminotransferase (ALT) at baseline and subsequent

normalization after 3 years (normal ALT limit being 30 U/L for males and

19 U/L for females). In nontreated patients, only the patients with

persistently normal ALT at both time points had significantly lower LSMs at the

follow-up measurement compared to baseline: 4.9 vs 5.3 kPa, respectively, in

patients who remained positive for HBsAg (P = 0.005) and 5.1 vs 5.4 kPa,

respectively, in patients who had HBsAg seroclearance (P = 0.026). In

patients who remained positive for HBsAg, independent factors associated with a

significant decline in LSM of ≥1 kPa included antiviral therapy

(P = 0.011) and the ALT levels at the follow-up time point (P = 0.024).

Thus, in patients with CHB, a significant decline in LSM after 3 years was

observed in treated patients with ALT normalization and in untreated patients

who had persistently normal ALT. Antiviral therapy and follow-up ALT levels were

independent significant factors associated with a decline in LSM.

© 2011 Blackwell Publishing Ltd.

PMID: 21692933 [PubMed - in process]