title: Low liver stiffness among cirrhotic patients with hepatitis B after prolonged treatment with nucleoside analogs.
abstract: OBJECTIVE
  Case reports and short-term clinical trials have suggested that treatment for chronic hepatitis B (CHB) may lead to improvement of cirrhosis. The aim of the present study was to measure liver stiffness in patients diagnosed with advanced fibrosis or cirrhosis prior to prolonged treatment with nucleoside or nucleotide analogs (NUCs) for CHB.
  
  
  METHODS
  Patients with CHB and advanced fibrosis or cirrhosis prior to treatment with NUCs for at least 1 year were offered inclusion in the study. We measured liver stiffness using transient elastography (TE) at follow-up. TE cut-off levels to Metavir classification for fibrosis stage F2, F3 and F4 were ≥7.2 kPa, ≥8.1, and ≥11.0 kPa, respectively.
  
  
  RESULTS
  Among 66 patients with a successful TE examination at follow-up, 53 patients (80%) had cirrhosis and 13 had (20%) advanced fibrosis (F3) prior to treatment. Median treatment duration was 50.5 months. Among patients with cirrhosis prior to treatment, 26 (49%) had liver stiffness below 11.0 kPa at follow-up, suggesting regression of cirrhosis. Among patients with advanced fibrosis (F3) prior to treatment, 10 (77%) had liver stiffness below 8.1 kPa after treatment, suggesting improvement of fibrosis.
  
  
  CONCLUSIONS
  Transient elastography examinations demonstrate that prolonged treatment with NUCs in patients with CHB results in low liver stiffness, suggesting regression of fibrosis in a majority of patients with advanced fibrosis or cirrhosis.
authors: Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark. ellensloth@dadlnet.dk
authors: Ellen Sloth
authors: ES
authors: Andersen
authors: Ola
authors: O
authors: Weiland
authors: Peter
authors: P
authors: Leutscher
authors: Henrik
authors: H
authors: Krarup
authors: Johan
authors: J
authors: Westin
authors: Belinda
authors: B
authors: Moessner
authors: Zbigniew
authors: Z
authors: Konopski
authors: Svein-Oskar
authors: SO
authors: Frigstad
authors: Mette
authors: M
authors: Kjær
authors: Peer Brehm
authors: PB
authors: Christensen
authors: Nina
authors: N
authors: Weis
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000328:Adult; D054459:Elasticity Imaging Techniques; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000627:therapeutic use; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D000068698:Tenofovir; D013997:Time Factors
chemical_list: D063065:Organophosphonates; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; C053001:adefovir; D000068698:Tenofovir; D000225:Adenine