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Am J Gastroenterol. 2017 Apr 4. doi: 10.1038/ajg.2017.93. [Epub ahead of print]
Improvement of Liver Fibrosis after Long-Term Antiviral Therapy Assessed by Fibroscan in Chronic Hepatitis B Patients With Advanced Fibrosis.
Chon YE1, Park JY2,3, Myoung SM4, Jung KS2,3, Kim BK2,3, Kim SU2,3, Kim DY2,3, Ahn SH2,3, Han KH2,3.
Author information
1 Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
2 Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
3 Yonsei Liver Center, Severance Hospital, Seoul, Korea.
4 Department of Medical Information and Administration, College of Health Science, Jungwon University, Goesan, Korea.
Abstract
OBJECTIVES:
Performing repeated liver biopsies to assess the improvement of liver fibrosis is impractical. The purpose of this prospective cohort study was to assess the improvement of liver fibrosis during antiviral treatment by serial liver stiffness (LS) measurement using Fibroscan in chronic hepatitis B (CHB) patients with advanced fibrosis.
METHODS:
Nucleos(t)ide analog-naive CHB patients with advanced fibrosis in histological findings (stage ≥F3), high viral load (hepatitis B virus DNA ≥2,000 IU/ml), and normal liver enzyme levels (<2 × upper normal limit) before starting antiviral treatment were included in this study. LS measurement was performed at baseline and annually for 5 years during antiviral treatment. Five-year fibrosis improvement was defined as LS value <7.2 kPa (<F3) at year 5.
RESULTS:
The mean LS value of 120 patients significantly decreased over time (14.5 kPa at baseline; 11.3 kPa at year 1; 9.6 kPa at year 2; 9.3 kPa at year 3; 8.6 kPa at year 4; and 8.3 kPa at year 5). Multivariate analysis showed that baseline LS value was the only predictor of 5-year fibrosis improvement (odds ratio, 0.907; 95% confidence interval, 0.838-0.980; P=0.014). Patients with low baseline LS values (<12.0 kPa) had a greater probability of experiencing significant fibrosis improvement than those with high baseline LS values (≥12.0 kPa) (81.5% vs. 29.0%, P<0.001).
CONCLUSIONS:
In CHB patients with advanced fibrosis receiving antiviral treatment, annual LS measurement revealed that fibrosis improvement slows but continues during treatment. Low LS value (<12.0 kPa) at baseline was a significant predictor for 5-year fibrosis improvement.Am J Gastroenterol advance online publication, 4 April 2017; doi:10.1038/ajg.2017.93.
PMID:
28374814
DOI:
10.1038/ajg.2017.93
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