J Clin Med. 2019 Dec 2;8(12). pii: E2101. doi: 10.3390/jcm8122101.
Evaluation of Point Shear Wave Elastography Using Acoustic Radiation Force Impulse Imaging for Longitudinal Fibrosis Assessment in Patients with HBeAg-Negative HBV Infection.
Graf C1, Mondorf A1, Knop V1, Peiffer KH1, Dietz J1, Friess J1, Wedemeyer H2,3, Buggisch P4, Mauss S5, Berg T6, Rausch M7, Sprinzl M8, Klinker H9, Hinrichsen H10, Bronowicki JP11, Haag S12, Hüppe D13, Lutz T14, Poynard T15, Zeuzem S1, Friedrich-Rust M1, Sarrazin C1,16, Vermehren J1.
Author information
1
Department of Internal Medicine 1, University Hospital Frankfurt, 60596 Frankfurt, Germany.
2
Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, 30625 Hannover, Germany.
3
Department of Gastroenterology and Hepatology, University Hospital Essen, 45147 Essen, Germany.
4
Institute for Interdisciplinary Medicine IFI, 20099 Hamburg, Germany.
5
Center for HIV and Hepatogastroenterology, 40237 Düsseldorf, Germany.
6
Department of Gastroenterology and Rheumatology, University Hospital Leipzig, 04103 Leipzig, Germany.
7
Practice of Internal Medicine, 10777 Berlin, Germany.
8
Department of Internal Medicine I, University Medical Centre of the Johannes Gutenberg-University, 55131 Mainz, Germany.
9
Department of Medicine II, Division of Hepatology, University Hospital Würzburg, 97080 Würzburg, Germany.
10
Gastroenterology-Hepatology Center, 24105 Kiel, Germany.
11
Hepato-Gastroenterology, Hopital Brabois- CHU Nancy, 54500 Vandoeuvre-les-Nancy, France.
12
Practice of Gastroenterology, 65189 Wiesbaden, Germany.
13
Practice of Hepatology, 44623 Herne, Germany.
14
Infektiologikum, 60596 Frankfurt, Germany.
15
BioPredictive, 75007 Paris, France.
16
Department of Gastroenterology, St. Josefs-Hospital, 65189 Wiesbaden, Germany.
Abstract
BACKGROUND:
Accurate assessment of hepatic fibrosis in patients with chronic HBeAg-negative Hepatitis B is of crucial importance not only to predict the long-term clinical course, but also to evaluate antiviral therapy indication. The aim of this study was to prospectively assess the utility of point shear wave elastography (pSWE) for longitudinal non-invasive fibrosis assessment in a large cohort of untreated patients with chronic HBeAg-negative hepatitis B virus (HBV) infection.
METHODS:
407 consecutive patients with HBeAg-negative HBV infection who underwent pSWE, transient elastography (TE) as well as laboratory fibrosis markers, including fibrosis index based on four factors (FIB-4), aspartate to platelet ratio index (APRI) and FibroTest, on the same day were prospectively followed up for six years. Patients were classified into one of the three groups: inactive carriers (IC; HBV-DNA <2000 IU/mL and ALT <40 U/L); grey zone group 1 (GZ-1; HBV DNA <2000 IU/mL and ALT >40 U/L); grey zone group 2 (GZ-2; HBV-DNA >2000 IU/mL and ALT <40 U/L).
RESULTS:
pSWE results were significantly correlated with TE (r = 0.29, p < 0.001) and APRI (r = 0.17; p = 0.005). Median pSWE values did not differ between IC, GZ-1 and GZ-2 patients (p = 0.82, p = 0.17, p = 0.34). During six years of follow-up, median pSWE and TE values did not differ significantly over time (TE: p = 0.27; pSWE: p = 0.05).
CONCLUSION:
Our data indicate that pSWE could be useful for non-invasive fibrosis assessment and follow-up in patients with HBeAg-negative chronic HBV infection.
KEYWORDS:
APRI; FIB-4; HBV; acoustic radiation force impulse imaging; fibrotest; non-invasive fibrosis assessment; point shear wave elastography; transient elastography
连续407例HBeAg阴性HBV感染患者接受了pSWE，瞬时弹性成像（TE）以及实验室纤维化标记，包括基于四个因素的纤维化指数（FIB-4），门冬氨酸与血小板比率指数（APRI）和FibroTest，同一天进行了长达六年的随访。患者被分为三类之一：无活动的携带者（IC； HBV-DNA <2000 IU / mL，ALT <40 U / L）；灰区组1（GZ-1; HBV DNA <2000 IU / mL和ALT> 40 U / L）;灰区组2（GZ-2; HBV-DNA> 2000 IU / mL和ALT <40 U / L）。
结果：