title: Assessment of hepatic fibrosis regression by transient elastography in patients with chronic hepatitis B treated with oral antiviral agents.
abstract: Transient elastography (TE) has been used as a non-invasive method for liver stiffness measurement (LSM) in patients with chronic liver disease. This study was performed to assess the change of LSM by TE and to assess its clinical usefulness during long-term oral antiviral therapy in patients with chronic hepatitis B (CHB). We retrospectively reviewed 83 CHB patients. The mean interval between two LSM was 411.5 ± 149.5 days. Initial and follow-up LSM was 16.15 ± 12.41 kPa and 11.26 ± 7.36 kPa, respectively (P < 0.001). The degree of regression of liver stiffness was -2.03 ± 0.36% per month. The fibrosis stage classified by LSM value improved in 37 (44.6%) patients during oral antiviral therapy. Of the 30 (36.1%) patients with LSM ≥ 14.1 kPa (cirrhosis) at 1st LSM, 12 (40%) proved to no longer have cirrhosis (≥ 1 decrease in fibrosis stage) at 2nd LSM. LSM significantly decreased in both baseline high (> upper limit of normal [ULN] × 2) and low (≤ ULN × 2) alanine aminotransferase groups during antiviral therapy (P < 0.001; P = 0.001, respectively). Long-term oral antiviral therapy resulted in the improvement of liver stiffness in a substantial portion of patients with CHB. TE may be used a useful clinical tool to assess disease progression in CHB patients.
authors.affiliation: Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. ; Liver Cirrhosis Clinical Research Center, Seoul, Korea.
authors.forename: Ja Kyung
authors.identifier: 0000-0001-5025-6846
authors.initials: JK
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Dae Won
authors.identifier: 0000-0002-0321-1140
authors.initials: DW
authors.lastname: Ma
authors.affiliation: Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. ; Liver Cirrhosis Clinical Research Center, Seoul, Korea.
authors.forename: Kwan Sik
authors.identifier: 0000-0002-3672-1198
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Yong-Han
authors.identifier: 0000-0002-3076-2327
authors.initials: YH
authors.lastname: Paik
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D054459:Elasticity Imaging Techniques; D005260:Female; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D000998:Antiviral Agents; D000410:Alanine Transaminase
keywords: Elasticity Imaging Techniques; Hepatitis B, Chronic; Liver Cirrhosis; Liver Stiffness; Oral Antiviral Agents
references.citation: Int J Infect Dis. 2012 Sep;16(9):e669-72
references.pmid: 22738792
references.citation: Gastroenterology. 2006 Mar;130(3):678-86
references.pmid: 16530509
references.citation: J Hepatol. 2003 Jan;38(1):98-103
references.pmid: 12480566
references.citation: J Gastroenterol Hepatol. 2006 Oct;21 Suppl 3:S84-7
references.pmid: 16958681
references.citation: Semin Liver Dis. 2004 Feb;24(1):89-97
references.pmid: 15085489
references.citation: Annu Rev Immunol. 1995;13:29-60
references.pmid: 7612225
references.citation: Hepatology. 2010 Sep;52(3):886-93
references.pmid: 20683932
references.citation: Hepatology. 2011 Jan;53(1):325-35
references.pmid: 21254180
references.citation: J Hepatol. 2003 Mar;38(3):257-65
references.pmid: 12586290
references.citation: Hepatology. 2006 Dec;44(6):1511-7
references.pmid: 17133503
references.citation: Hepatology. 2009 Sep;50(3):661-2
references.pmid: 19714720
references.citation: Gastroenterology. 2008 May;134(6):1655-69
references.pmid: 18471545
references.citation: J Viral Hepat. 2009 Jan;16(1):36-44
references.pmid: 18673426
references.citation: Gastroenterology. 2008 Apr;134(4):960-74
references.pmid: 18395077
references.citation: J Viral Hepat. 2007 May;14(5):360-9
references.pmid: 17439526
references.citation: Lancet. 2013 Feb 9;381(9865):468-75
references.pmid: 23234725
references.citation: PLoS One. 2012;7(4):e35825
references.pmid: 22536445
references.citation: PLoS One. 2012;7(9):e44930
references.pmid: 23049764
references.citation: N Engl J Med. 2004 Oct 7;351(15):1521-31
references.pmid: 15470215
references.citation: Aliment Pharmacol Ther. 2010 Aug;32(3):498-505
references.pmid: 20491742
references.citation: Clin Liver Dis. 2007 Nov;11(4):797-816, viii
references.pmid: 17981229
references.citation: Hepatology. 2011 Mar;53(3):885-94
references.pmid: 21319193
references.citation: JAMA. 2006 Jan 4;295(1):65-73
references.pmid: 16391218
references.citation: Gastroenterology. 2003 Jan;124(1):105-17
references.pmid: 12512035
references.citation: Hepatology. 2003 Dec;38(6):1449-57
references.pmid: 14647056
references.citation: Ultrasound Med Biol. 2003 Dec;29(12):1705-13
references.pmid: 14698338
references.citation: Am J Gastroenterol. 2008 Nov;103(11):2776-83
references.pmid: 18721244