Longitudinal change of liver stiffness by transient elestography in chronic hepatitis B patients treated with nucleos(t)ide analogue.
BACKGROUND
Liver stiffness measurement (LSM) by transient elastography is a non-invasive method to assess liver fibrosis. Decline in LSM value has been reported after antiviral treatment (AVT) using nucleos(t)ide analogues (NUCs) in chronic hepatitis B (CHB) patients, however, factors associated with changes in LSM during AVT remains unclear.


METHODS
A total of 76 CHB patients who received AVT with NUCs and had serial LSM (median duration: 16 months, range: 12 to 35 months) during AVT were analyzed. Complete virological response (CVR) was defined when hepatitis B virus DNA level was undetectable by real-time PCR assay (< 50 copies/mL).


RESULTS
LSM value had significantly decreased after AVT with NUCs [median (quartile): 6.5 (4.7-9.2) to 5.3 (3.9-6.7), P<0.001]. The median change of LSM value/year was -0.8 (range: -9.5∼4.9). The annual change of LSM value was associated with baseline total bilirubin levels, HBeAg status and achievement of CVR during follow-up in univariable analysis, and achievement of CVR during follow-up was an only independent factor associated with the annual change of LSM value [beta coefficients (95% confidence interval)=-0.29 (-2.81∼-0.26), P=0.02]. The annual LSM change was significantly different between those who achieved and did not achieve CVR (median change: -1.08/year vs. 0.26/year, P<0.01), and more patients with CVR had decrease in LSM value (89% (47/53) vs. 35% (8/23), P<0.01).


CONCLUSIONS
A significant decrease in LSM value was observed in CHB patients after AVT with NUCs. Achievement of CVR was significant factor associated with change in LSM value. Achieving CVR might be a key to decrease LSM value during AVT with NUCs.
Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, 761-1, Sanggye 7-dong, Nowon-gu, Seoul 139-707, Republic of Korea.
Won
W
Jang
Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, 761-1, Sanggye 7-dong, Nowon-gu, Seoul 139-707, Republic of Korea.
Sung In
SI
Yu
Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, 761-1, Sanggye 7-dong, Nowon-gu, Seoul 139-707, Republic of Korea.
Dong Hyun
DH
Sinn
Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, 761-1, Sanggye 7-dong, Nowon-gu, Seoul 139-707, Republic of Korea.
Sang Hoon
SH
Park
Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, 761-1, Sanggye 7-dong, Nowon-gu, Seoul 139-707, Republic of Korea.
Hyun
H
Park
Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, 761-1, Sanggye 7-dong, Nowon-gu, Seoul 139-707, Republic of Korea.
Ji Young
JY
Park
Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, 761-1, Sanggye 7-dong, Nowon-gu, Seoul 139-707, Republic of Korea.
Tae Joo
TJ
Jeon
Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, 761-1, Sanggye 7-dong, Nowon-gu, Seoul 139-707, Republic of Korea.
Tae Hoon
TH
Oh
Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, 761-1, Sanggye 7-dong, Nowon-gu, Seoul 139-707, Republic of Korea.
Won Chang
WC
Shin
Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, 761-1, Sanggye 7-dong, Nowon-gu, Seoul 139-707, Republic of Korea. Electronic address: wcc829@paik.ac.kr.
Won-Choong
WC
Choi
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D054459:Elasticity Imaging Techniques; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009705:Nucleosides / Q000627:therapeutic use*; D009711:Nucleotides / Q000627:therapeutic use*; D012189:Retrospective Studies
D000998:Antiviral Agents; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D009705:Nucleosides; D009711:Nucleotides; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin