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

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http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2010.01428.x/abstract

Significant changes in liver stiffness measurements in patients with chronic

hepatitis B: 3-year follow-up study

J. Fung, C.-L. Lai, D. K.-H. Wong, W.-K. Seto, I. Hung, M.-F. YuenArticle first

published online: 7 JAN 2011

DOI: 10.1111/j.1365-2893.2010.01428.x

© 2011 Blackwell Publishing Ltd

Issue

Journal of Viral Hepatitis

Early View (Articles online in advance of print)

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.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2010.01428.x/abstract

Significant changes in liver stiffness measurements in patients with chronic

hepatitis B: 3-year follow-up study

J. Fung, C.-L. Lai, D. K.-H. Wong, W.-K. Seto, I. Hung, M.-F. YuenArticle first

published online: 7 JAN 2011

DOI: 10.1111/j.1365-2893.2010.01428.x

© 2011 Blackwell Publishing Ltd

Issue

Journal of Viral Hepatitis

Early View (Articles online in advance of print)

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.