title: Hepatic venous pressure gradient as a predictor of fibrosis in chronic liver disease because of hepatitis B virus.
abstract: 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.
authors.affiliation: Department of Gastroenterology, G. B. Pant Hospital, New Delhi, India.
authors.forename: Manoj
authors.initials: M
authors.lastname: Kumar
authors.forename: Ashish
authors.initials: A
authors.lastname: Kumar
authors.forename: Syed
authors.initials: S
authors.lastname: Hissar
authors.forename: Pankaj
authors.initials: P
authors.lastname: Jain
authors.forename: Archana
authors.initials: A
authors.lastname: Rastogi
authors.forename: Deepak
authors.initials: D
authors.lastname: Kumar
authors.forename: Puja
authors.initials: P
authors.lastname: Sakhuja
authors.forename: Shiv K
authors.initials: SK
authors.lastname: Sarin
mesh_terms: 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