title: Transient elastography and biomarkers for liver fibrosis assessment and follow-up of inactive hepatitis B carriers.
abstract: BACKGROUND
  Non invasive methods for fibrosis evaluation remain to be validated longitudinally in hepatitis B.
  
  
  OBJECTIVE
  To evaluate longitudinally transient elastography (TE) and biomarkers for liver fibrosis assessment and follow-up of hepatitis B virus (HBV) inactive carriers.
  
  
  METHODS
  Three hundred and twenty-nine consecutive HBeAg-negative HBV patients (201 inactive carriers) who underwent TE, Fibrotest and aspartate to platelet ratio index (APRI) the same day were studied.
  
  
  RESULTS
  TE (median 4.8 vs. 6.8 kPa, P < 0.0001), Fibrotest (0.16 vs. 0.35, P < 0.0001) and APRI values (0.28 vs. 0.43, P < 0.0001) were significantly lower in inactive carriers than in the remaining patients whereas they did not differ among inactive carriers according to HBV DNA levels. In 82 inactive carriers with repeated examinations, although differences were observed among individual patients, TE values did not differ significantly over time (median intra-patient changes at end of follow-up relative to baseline: -0.2 kPa, P = 0.12). Conversely, significant fluctuations were observed for Fibrotest (+0.03, P = 0.012) and APRI (-0.01, P < 0.05). Eleven inactive carriers (5.5%) had initial elevated TE values (>7.2 kPa) confirmed during follow-up in two with significant fibrosis (F2 and F3) on liver biopsy.
  
  
  CONCLUSIONS
  Non-invasive tools, particularly TE, could be useful, in addition to HBV DNA and transaminase levels, for follow-up of HBV inactive carriers as well as better selection of patients who require a liver biopsy.
authors.affiliation: Hôpital Haut-Lévêque, Centre Hospitalier Universitaire Bordeaux, Pessac, France. laurent.castera@bjn.aphp.fr
authors.forename: L
authors.initials: L
authors.lastname: Castéra
authors.forename: P-H
authors.initials: PH
authors.lastname: Bernard
authors.forename: B
authors.initials: B
authors.lastname: Le Bail
authors.forename: J
authors.initials: J
authors.lastname: Foucher
authors.forename: P
authors.initials: P
authors.lastname: Trimoulet
authors.forename: W
authors.initials: W
authors.lastname: Merrouche
authors.forename: P
authors.initials: P
authors.lastname: Couzigou
authors.forename: V
authors.initials: V
authors.lastname: de Lédinghen
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D002353:Carrier State; D003430:Cross-Sectional Studies; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000000981:diagnostic imaging; D006515:Hepatitis B virus; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D013223:Statistics as Topic
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase