title: Reduction of liver stiffness following resolution of acute flares of chronic hepatitis B.
abstract: BACKGROUND
  Measuring liver stiffness is becoming more popular as a non-invasive tool for assessing liver fibrosis.
  
  
  OBJECTIVE
  To assess the effect of severe hepatitis B flare on liver stiffness and determine factors that correlate with liver stiffness measurements.
  
  
  METHODS
  Twenty-nine patients with severe hepatitis B flare (ALT > 10 × upper limit of normal) were followed up for 1 year. Serial transient elastography was performed at the time of flare, 3-6, and 12 months after flare.
  
  
  RESULTS
  At the time of flare, the median liver stiffness was 16.8 kPa, with no patients having normal liver stiffness (<6 kPa). There was a significant decrease in liver stiffness from baseline to 3-6 months (16.8 vs. 7.9 kPa, respectively, P < 0.001), and a further smaller decline from 3-6 to 12 months (7.9 vs. 6.9 kPa, respectively, P = 0.039). By 12 months, 10 (34%) had normalized their liver stiffness. Baseline parameters which correlated with liver stiffness include bilirubin, ALT, albumin, prothrombin time and platelet levels (all P < 0.05).
  
  
  CONCLUSIONS
  Liver stiffness was increased in patients with severe hepatitis B flares, with return to near normal levels by 6 months. Transient elastography for proper assessment of liver fibrosis should be performed at least 6 months after flare.
authors.affiliation: Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China.
authors.forename: James
authors.initials: J
authors.lastname: Fung
authors.forename: Ching-Lung
authors.initials: CL
authors.lastname: Lai
authors.forename: David
authors.initials: D
authors.lastname: But
authors.forename: Axel
authors.initials: A
authors.lastname: Hsu
authors.forename: Wai-Kay
authors.initials: WK
authors.lastname: Seto
authors.forename: Charles
authors.initials: C
authors.lastname: Cheng
authors.forename: Danny Ka-Ho
authors.initials: DK
authors.lastname: Wong
authors.forename: Man-Fung
authors.initials: MF
authors.lastname: Yuen