Dynamic changes in liver stiffness during the course of acute hepatitis A.
OBJECTIVE
Several recent studies have suggested that hepatic necroinflammation can alter the results of liver stiffness measurements (LSMs) obtained using the FibroScan device. However, the precise relationship between acute hepatic inflammation and LSMs remains unclear. The aim of this study was therefore to evaluate the dynamic changes in LSMs during the course of acute hepatic inflammation.


METHODS
Thirty-one patients with acute hepatitis A (AHA) were enrolled in this study (mean +/- SD age 29 +/- 7 years; 32.3% male). Only AHA patients who visited our hospital before their alanine aminotransferase (ALT) levels peaked were included. The day when AHA-associated symptoms began was considered as Day 0. Serum levels of ALT and bilirubin (BIL), and the international normalized ratio (INR) were measured every 2 days, as were LSMs, until the peak levels of all parameters were identified. Subsequently, these parameters were measured every 1-2 weeks until they had normalized.


RESULTS
Peak serum levels of ALT and BIL, the INR, and LSMs were 3723 +/- 1513 IU/l, 5.8 +/- 2.4 mg/dl, 1.3 +/- 0.3, and 11.9 +/- 5.7 kPa, respectively. The time taken for LSMs to peak from Day 0 (8 +/- 2 days) differed significantly from that for ALT (5 +/- 1 days), BIL (10 +/- 4 days), and INR (5 +/- 1 days). LSMs had normalized (< or = 5.5 kPa) in all patients at 34 +/- 17 days after Day 0. ALT level and the INR were significantly associated with peak LSMs and BIL level and the INR with the time taken for normalization of LSMs.


CONCLUSIONS
LSMs changed dynamically during the course of AHA. The pattern of change appears to be related to the severity of hepatic necroinflammation.
Seo
Yeon Seok
YS
Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea.
Lee
Kwang Gyun
KG
Jung
Eun Suk
ES
An
Hyonggin
H
Park
Sanghoon
S
Keum
Bora
B
Yim
Hyung Joon
HJ
Jeen
Yoon Tae
YT
Chun
Hoon Jai
HJ
Kim
Chang Duck
CD
Ryu
Ho Sang
HS
Um
Soon Ho
SH
D000208:Acute Disease; D000328:Adult; D015415:Biomarkers / Q000097:blood; D004548:Elasticity; D054459:Elasticity Imaging Techniques; D005260:Female; D006506:Hepatitis A / Q000473:pathology*; D006801:Humans; D016014:Linear Models; D008099:Liver / Q000473:pathology*; D008111:Liver Function Tests; D008297:Male; D018709:Statistics, Nonparametric
D015415:Biomarkers