Reduction of liver stiffness by antiviral therapy in chronic hepatitis B

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http://www.springerlink.com/content/b13t1u44580026u5/

Journal of Gastroenterology

DOI: 10.1007/s00535-011-0444-4Online Firstâ„¢

Original Article—Liver, Pancreas, and Biliary Tract

Reduction of liver stiffness by antiviral therapy in chronic hepatitis B

Keisuke Osakabe, Naohiro Ichino, Toru Nishikawa, Hiroko Sugiyama, Miho Kato,

Shiho Kitahara, Senju Hashimoto, Naoto Kawabe, Masao Harata and Yoshifumi Nitta,

et al.

Abstract

Background

Liver stiffness (LS) has been reported to correlate with fibrosis stage (F). The

correlation between LS and fibrosis stage and the reduction of LS by antiviral

therapy were examined in patients with hepatitis B infection.

Methods

LS was measured by FibroScan in 212 patients infected with hepatitis B virus.

Liver biopsies were done in 51 patients. Changes of LS were assessed in 29

patients treated with nucleotide or nucleoside analogs and 52 patients without

antiviral therapy.

Results

LS was significantly correlated with fibrosis stage (Ï = 0.686, P < 0.0001).

The optimal cut-off values of LS were 7.1 kPa for F ≥ 2, 10.7 kPa for F ≥ 3,

and 16.0 kPa for F4. LS was significantly reduced by antiviral therapy, from

12.9 (range 6.2–17.9) kPa to 6.6 (4.4–10.3) kPa measured at an interval of

512 (range 366–728) days (P < 0.0001). Eleven of 19 (58%) patients with

baseline fibrosis stages of F3-4 deduced from LS had 2-point or greater

reductions of deduced stage at the last LS measurement. The change ratio of

hyaluronic acid (P = 0.0390) was associated with a 2-point or greater reduction

of deduced fibrosis stage. Without antiviral therapy, LS tended to increase,

increasing from 6.1 (range 3.9–8.5) kPa to 6.3 (range 4.4–9.7) kPa at an

interval of 422 (range 358–709) days (P = 0.0682).

Conclusions

LS was significantly correlated with fibrosis stage in patients with chronic

hepatitis B. The reduction of LS by antiviral therapy was significantly

correlated with the reduction of hyaluronic acid. Thus, we conclude that LS can

be useful to assess the progression and regression of liver fibrosis stage

noninvasively.