Hepatic venous pressure gradient as a predictor of fibrosis in chronic liver disease because of hepatitis B virus.
BACKGROUND
Liver biopsy has been considered to be a gold standard for assessing hepatic fibrosis. Sample variability, interobserver variability and step-wise evaluation limit its use. Hepatic venous pressure gradient (HVPG) correlates with hepatic fibrosis in chronic liver disease (CLD) because of hepatitis C.


OBJECTIVE
To evaluate the utility of HVPG for assessing hepatic fibrosis in patients with hepatitis B virus (HBV)-related CLD.


METHODS
Sixty-one patients with HBV-related CLD who underwent both liver biopsy and hepatic haemodynamic studies were studied.


RESULTS
Forty-nine (80.3%) patients had clinically significant portal hypertension (PHT) (HVPG>or=10 mmHg), 39 (63.9%) severe PHT (i.e. HVPG>or=12 mmHg), six (9.8%) HVPG<or=5 mmHg and another six (9.8%) had preclinical PHT (i.e. HVPG>5 but <10 mmHg). A positive correlation between HVPG and fibrosis score was found (r=0.436, P<0.001). In patients with HVPG<10 or <12 mmHg there was a significant correlation with fibrosis score (r=0.603, P=0.029 and r=0.887, P<0.001 respectively). A positive correlation also existed in patients with HVPG>or=10 mmHg and in patients with HVPG>or=12 mmHg (r=0.512, P<or=0.001 and r=0.543, P<0.001 respectively). Receiver operating characteristic curve of HVPG for the prediction of advanced fibrosis (stage>or=3) had an area under curve of 0.906. HVPG value above 13.0 mmHg had a sensitivity of 79% and a specificity of 89% for predicting advanced fibrosis on histology.


CONCLUSIONS
HVPG correlates well with the degree of histological fibrosis in patients with HBV-related CLD.
Kumar
Manoj
M
Department of Gastroenterology, G. B. Pant Hospital, New Delhi, India.
Kumar
Ashish
A
Hissar
Syed
S
Jain
Pankaj
P
Rastogi
Archana
A
Kumar
Deepak
D
Sakhuja
Puja
P
Sarin
Shiv K
SK
D000328:Adult; D005260:Female; D006503:Hepatic Veins / Q000502:physiology; D006509:Hepatitis B / Q000150:complications / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D017082:Portal Pressure / Q000502:physiology