title: Impact of Fibroscan on management of chronic viral hepatitis in clinical practice.
abstract: BACKGROUND
  Liver stiffness measurement (LSM) using Fibroscan is an increasingly popular non-invasive method for quantifying liver fibrosis in patients with chronic viral hepatitis. We aimed to explore potential impact of Fibroscan on clinical management.
  
  
  METHODS
  133 patients with chronic hepatitis B (HBV, n = 75) or C (HCV, n = 58) underwent Fibroscan measurement. LSM results were compared with liver biopsy results, ultrasound, and APRI-scores, and the impact of LSM on clinical management was evaluated.
  
  
  RESULTS
  LSM results indicated fibrosis stage F0-F1 in 84 patients (63%), F2 in 28 (21%), F3 in 8 (6%), and F4 in 13 patients (10%). Nineteen patients had liver biopsies within one year of LSM. In ten patients, LSM and biopsy showed the same fibrosis stage, in 8 there was one stage difference, and in 1 three stages difference. Ultrasound only showed cirrhosis in three patients, who all exhibited advanced cirrhosis at LSM. There was a statistically significant, but weak correlation between LSM results and APRI scores (r = 0.31, pvalue < 0.001). LSM results changed clinical management in 39% of patients (55 cases): in 15 patients antiviral treatment was indicated, in 21 patients surveillance for hepatocellular carcinoma was indicated, and 19 successfully treated hepatitis C patients could be discharged from clinical follow-up in absence of severe fibrosis or cirrhosis.
  
  
  CONCLUSIONS
  LSM appears to be a valuable non-invasive tool to manage patients with chronic viral hepatitis in clinical practice.
authors.affiliation: Van Creveldkliniek, Department of Haematology, Utrecht, The Netherlands.
authors.forename: Dietje
authors.initials: D
authors.lastname: Fransen van de Putte
authors.forename: Renske
authors.initials: R
authors.lastname: Blom
authors.forename: Hanneke
authors.initials: H
authors.lastname: van Soest
authors.forename: Marco
authors.initials: M
authors.lastname: Mundt
authors.forename: Claudia
authors.initials: C
authors.lastname: Verveer
authors.forename: Joop
authors.initials: J
authors.lastname: Arends
authors.forename: Robert E
authors.initials: RE
authors.lastname: de Knegt
authors.forename: Eveline
authors.initials: E
authors.lastname: Mauser-Bunschoten
authors.forename: Karel
authors.initials: K
authors.lastname: van Erpecum
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D054459:Elasticity Imaging Techniques; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D019698:Hepatitis C, Chronic / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000628:therapy / Q000821:virology; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult
chemical_list: D000998:Antiviral Agents