title: Noninvasive assessments of liver fibrosis with transient elastography and Hui index predict survival in patients with chronic hepatitis B.
abstract: OBJECTIVE
  The prognostic role of noninvasive assessments of liver fibrosis has been evolving. Our aim was to investigate the prognostic value of liver stiffness measurement (LSM) with transient elastography and serum-based Hui index to predict hepatic events and deaths in chronic hepatitis B (CHB) patients.
  
  
  METHODS
  The main prospective cohort included 1555 consecutive CHB patients referred for transient elastography examination; a subgroup of 980 patients underwent follow-up assessments at least 3 years later formed the serial cohort. Cox proportional hazard model was performed to determine the relationship of LSM, Hui index and other clinical variables with hepatic events and deaths.
  
  
  RESULTS
  During a mean follow-up of 69 ± 9 months, 119 patients (7.6%) developed hepatic events or deaths. Hepatic event-free survival was significantly decreased with increasing stages of LSM and Hui index. The 5-year cumulative probability of hepatic event-free survival of patients of Stage 1-7 of LSM were 99.3%, 98.8%, 95.7%, 90.9%, 89.6%, 74.6%, and 50.0%, respectively; that of Stage 1 to 3 of Hui index were 98.2%, 93.1%, and 77.5%, respectively. Independent predictors of hepatic event-free survival were age, baseline LSM, and follow-up Hui index. Serum ALT and body mass index affected the accuracy of prediction by LSM. Patients remained early stages of LSM or Hui index at follow-up visit had better survival compared to those remained at late stages.
  
  
  CONCLUSIONS
  Baseline and change in noninvasive parameters of liver fibrosis, LSM and Hui index, are accurate to predict hepatic event-free survival in CHB patients.
authors.affiliation: Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Grace Lai-Hung
authors.initials: GL
authors.lastname: Wong
authors.forename: Henry Lik-Yuen
authors.initials: HL
authors.lastname: Chan
authors.forename: Zhuo
authors.initials: Z
authors.lastname: Yu
authors.forename: Catherine Ka-Yan
authors.initials: CK
authors.lastname: Wong
authors.forename: Calvin
authors.initials: C
authors.lastname: Leung
authors.forename: Patricia Po-Lai
authors.initials: PP
authors.lastname: Ho
authors.forename: Candace Yim
authors.initials: CY
authors.lastname: Chan
authors.forename: Vivian Chi-Yee
authors.initials: VC
authors.lastname: Chung
authors.forename: Zhan Cham-Yan
authors.initials: ZC
authors.lastname: Chan
authors.forename: Yee-Kit
authors.initials: YK
authors.lastname: Tse
authors.forename: Angel Mei-Ling
authors.initials: AM
authors.lastname: Chim
authors.forename: Tina Kit-Ting
authors.initials: TK
authors.lastname: Lau
authors.forename: Hoi-Yun
authors.initials: HY
authors.lastname: Chan
authors.forename: Chi-Hang
authors.initials: CH
authors.lastname: Tse
authors.forename: Vincent Wai-Sun
authors.initials: VW
authors.lastname: Wong
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D015331:Cohort Studies; D018572:Disease-Free Survival; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000401:mortality*; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D042764:Receptors, TIE; D012720:Severity of Illness Index; D000637:Transaminases / Q000097:blood*
chemical_list: D015415:Biomarkers; D000637:Transaminases; D042764:Receptors, TIE
keywords: cirrhosis; clinical events; death; hepatocellular carcinoma; liver stiffness measurement