Acute viral hepatitis increases liver stiffness values measured by transient elastography.
Liver tissue alterations other than fibrosis may have an impact on liver stiffness measurement. In this study we evaluated 18 patients without a previous clinical history of liver disease, consecutively admitted for acute viral hepatitis. In each patient, aminotransferase determination and liver stiffness measurement were performed on the same study day, at 3 different points: (1) peak increase in aminotransferase; (2) aminotransferase 50% or less of the peak; (3) aminotransferase levels <or=2x the upper limit of normal. In all patients, the degree of liver stiffness at the time of the peak increase in aminotransferases exceeded the cutoff values proposed for the prediction of significant fibrosis or cirrhosis. A progressive significant reduction in liver stiffness values was observed (P < 0.0001) in the follow-up period in parallel with the reduction of aminotransferase levels (P < 0.0001). Moreover, a statistically significant, positive correlation between aminotransferases and liver stiffness measurement (LSM) at the onset of acute viral hepatitis was found (r = 0.53, P = 0.02 and r = 0.51, P = 0.03 for alanine aminotransferase and aspartate aminotransferase, respectively). In conclusion, the extent of necroinflammatory activity needs to be carefully considered in future studies aimed at further validating transient elastography, particularly in patients with absent or low-stage liver fibrosis (in other words, F0-F2 METAVIR). LSM does not represent a reliable instrument to detect the presence of advanced fibrosis and cirrhosis in patients presenting with a clinical picture of acute hepatitis.
Arena
Umberto
U
Dipartimento di Medicina Interna, Università degli Studi di Firenze/Azienda Ospedaliero Universitaria Careggi Firenze, Italy.
Vizzutti
Francesco
F
Corti
Giampaolo
G
Ambu
Silvia
S
Stasi
Cristina
C
Bresci
Silvia
S
Moscarella
Stefania
S
Boddi
Vieri
V
Petrarca
Antonio
A
Laffi
Giacomo
G
Marra
Fabio
F
Pinzani
Massimo
M
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006505:Hepatitis / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D019934:International Normalized Ratio; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase