Prognostic significance of liver stiffness for hepatocellular carcinoma and mortality in HBeAg-negative chronic hepatitis B

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http://www.ingentaconnect.com/content/bsc/jvh/2011/00000018/00000010/art00035

Prognostic significance of liver stiffness for hepatocellular carcinoma and

mortality in HBeAg-negative chronic hepatitis B

Authors: Fung, J.; Lai, C.-L.; Seto, W.-K.; Wong, D. K.-H.; Yuen, M.-F.

Source: Journal of Viral Hepatitis, Volume 18, Number 10, 1 October 2011 , pp.

738-744(7)

Publisher: Wiley-Blackwell

Abstract:

Summary.  The prognostic value of liver stiffness measurements for chronic

hepatitis B (CHB) is not known. The present study aimed to investigate the use

of transient elastography in predicting hepatocellular carcinoma (HCC)

development and mortality in patients with CHB. Five hundred and twenty-eight

patients with HBeAg-negative CHB underwent liver stiffness measurements and were

prospectively followed up every 3-6 months for a median length of 35 months.

The patients were divided into those with liver stiffness <10 kPa (group 1)

and ≥10 kPa (group 2). Of the 528 patients, 324 (61%) were men. The median

age was 42 years. Compared with group 1, group 2 had a higher percentage of

men, with higher median levels of age, liver biochemistry, and viral load. At

the third year of follow-up, the cumulative incidence of HCC was higher in group

2 compared with group 1 (9%vs 0%, respectively, P < 0.001). The cumulative

liver-related mortality was also higher in group 2 compared to group 1 (4%vs 0%,

respectively, P < 0.001). After multivariate analysis, only liver stiffness

measurement (LSM) was significantly associated with HCC development and

mortality. There was also a higher cumulative incidence of hepatitis flares in

group 2 compared to group 1 (46%vs 14%, respectively, P = 0.001) in patients

with normal ALT, with higher LSM and AST being significantly associated with

subsequent flares. In HBeAg-negative CHB patients, a liver stiffness measurement

of ≥10 kPa was associated with a significantly increased risk of subsequent

HCC development and mortality.

Document Type: Research article

DOI: 10.1111/j.1365-2893.2010.01355.x

Affiliations:1: Department of Medicine, The University of Hong Kong, Pokfulam

Road Queen Hospital, Hong Kong SAR

Publication date: 2011-10-01

[Guest guest]

http://www.ingentaconnect.com/content/bsc/jvh/2011/00000018/00000010/art00035

Prognostic significance of liver stiffness for hepatocellular carcinoma and

mortality in HBeAg-negative chronic hepatitis B

Authors: Fung, J.; Lai, C.-L.; Seto, W.-K.; Wong, D. K.-H.; Yuen, M.-F.

Source: Journal of Viral Hepatitis, Volume 18, Number 10, 1 October 2011 , pp.

738-744(7)

Publisher: Wiley-Blackwell

Abstract:

Summary.  The prognostic value of liver stiffness measurements for chronic

hepatitis B (CHB) is not known. The present study aimed to investigate the use

of transient elastography in predicting hepatocellular carcinoma (HCC)

development and mortality in patients with CHB. Five hundred and twenty-eight

patients with HBeAg-negative CHB underwent liver stiffness measurements and were

prospectively followed up every 3-6 months for a median length of 35 months.

The patients were divided into those with liver stiffness <10 kPa (group 1)

and ≥10 kPa (group 2). Of the 528 patients, 324 (61%) were men. The median

age was 42 years. Compared with group 1, group 2 had a higher percentage of

men, with higher median levels of age, liver biochemistry, and viral load. At

the third year of follow-up, the cumulative incidence of HCC was higher in group

2 compared with group 1 (9%vs 0%, respectively, P < 0.001). The cumulative

liver-related mortality was also higher in group 2 compared to group 1 (4%vs 0%,

respectively, P < 0.001). After multivariate analysis, only liver stiffness

measurement (LSM) was significantly associated with HCC development and

mortality. There was also a higher cumulative incidence of hepatitis flares in

group 2 compared to group 1 (46%vs 14%, respectively, P = 0.001) in patients

with normal ALT, with higher LSM and AST being significantly associated with

subsequent flares. In HBeAg-negative CHB patients, a liver stiffness measurement

of ≥10 kPa was associated with a significantly increased risk of subsequent

HCC development and mortality.

Document Type: Research article

DOI: 10.1111/j.1365-2893.2010.01355.x

Affiliations:1: Department of Medicine, The University of Hong Kong, Pokfulam

Road Queen Hospital, Hong Kong SAR

Publication date: 2011-10-01