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1808
Dynamic changes of liver stiffness predict histological
reverse of liver fibrosis in chronic hepatitis B patients
treated with entecavir
Yuanyuan Kong1, Xiaoning Wu2,1, Yameng Sun2,1, Bo Feng3,
Yimin Mao4, Wei Jiang5, Lungen Lu6, Yongpeng Chen7, Jihong
Sun8, Xueen Liu9, Jilin Cheng10, Jialing Zhou2,1, Lin Wang2,1, Xiaojuan
Ou2,1, Hui Zhang11, Jidong Jia2,1, Hong You2,1; 1National
Clinical Research Center for Digestive Disease, Beijing Friendship
Hospital, Capital Medical University, Beijing, China; 2Liver
Research Center, Beijing Friendship Hospital, Capital Medical University,
Beijing, China; 3Peking University People’s Hospital, Beijing,
China; 4Renji Hospital, Shanghai Jiaotong University School
of Medicine, Shanghai, China; 5Zhongshan Hospital, Fudan University,
Shanghai, China; 6Shanghai General Hospital, Shanghai
Jiaotong University School of Medicine, Shanghai, China; 7Nanfang
Hospital, Southern Medical University,, Guangzhou, China;
8Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University,
Zhejiang, China; 9Peking University Health Science Center,
Beijing, China; 10Shanghai Public Health Clinical Center of Fudan
University, Shanghai, China; 11Department of Biostatistics, St Jude
Children’s Research Hospital, Memphis, TN
Aim: The dynamic change of liver stiffness measurement
(LSM) and its relation to histological reverse of liver fibrosis
in chronic hepatitis B (CHB) patients on antiviral therapy were
still unknown. The aim of the present study was to elucidate the
predicative value of dynamic change of LSM for histological
reverse of liver fibrosis in CHB patients treated with entecavir.
Material and methods: We measured HBV DNA, liver function
tests and LSM in CHB patients at baseline and every 26 weeks
during a 78-week entecavir therapy. Liver biopsies were taken
before and 78 weeks of treatment and histological reverse of
liver fibrosis was defined as Ishak fibrosis score decreased
>=1. Piecewise linear mixed-effects model was used to exam-
the dynamic changes in liver stiffness. Results: Among 93
CHB patients on entecavir therapy, histological reverse of liver
fibrosis was observed in 44.1%. Dynamic changes of liver
stiffness measurement (LSM) showed a two-phase declining
manner. The fast-declining phase was seen after 26 weeks
of treatment: in the reverse group the LSM went down from
12.6 Kpa to 7.6 Kpa (Rate of decrease=39.7%), whereas
in the non-reverse group it went down from 11.3 Kpa to 8.7
Kpa (Rate of decrease=23.0%). The slow-declining phase was
observed from 26 to 78 weeks of treatment: in reversed group
the LSM further went down to 7.1 Kpa and 6.4 Kpa at week 52
and 78 week, whereas in the non-reverse group the LSM was
8.4 Kpa and 7.7 Kpa, respectively. Multivariate regression
analysis showed that histological fibrosis reverse was associated
with patient age, histological inflammation score, and
changes of LSM. The AUROC of liver fibrosis prognostic model
for prediction of reverse was 0.73 (95%CI: 0.60-0.85). Conclusion:
Dynamic changes of LSM could predict histological
liver fibrosis reverse in CHB patients treated with entecavir.
Disclosures:
Jidong Jia - Consulting: BMS, Gilead, Abbive
The following people have nothing to disclose: Yuanyuan Kong, Xiaoning Wu,
Yameng Sun, Bo Feng, Yimin Mao, Wei Jiang, Lungen Lu, Yongpeng Chen,
Jihong Sun, Xueen Liu, Jilin Cheng, Jialing Zhou, Lin Wang, Xiaojuan Ou, Hui
Zhang, Hong You
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发表于 2016-10-21 15:34
