接受抗病毒治疗的慢性乙型肝炎患者肝脏硬度的动态变化

StephenW

接受抗病毒治疗的慢性乙型肝炎患者肝脏硬度的动态变化
Alin Lazar 1、Ioan Sporea 1、Alexandru Popa 1、Raluca Lupusoru 2、Diana Gherhardt 1、Ruxandra Mare 1、Alexandru Apostu 3、Madalina Hnatiuc 1、Roxana şirli 1
隶属关系
隶属关系

    1
    胃肠病学和肝病学部，胃肠病学和肝病学高级研究中心，“Victor Babeş”医药大学，罗马尼亚蒂米什瓦拉 300041。
    2个
    生物系统建模和数据分析中心，功能科学系，医学院，“Victor Babeş”医药大学，罗马尼亚蒂米什瓦拉 300041。
    3
    “Victor Babeş”医药大学心血管疾病研究所高级研究中心心脏病科、内科门诊、预防和心血管恢复科，罗马尼亚蒂米什瓦拉 300041。

    PMID：36359490 DOI：10.3390/diagnostics12112646

抽象的

这是一项回顾性单中心研究，包括 87 名受试者。所有受试者均患有慢性乙型肝炎或 HBV 肝硬化，并接受了超过一年的核苷（酸）类似物 (NUC) 治疗。该研究旨在评估在 64 个月的中位间隔期间通过瞬时弹性成像 (TE) 测量的肝脏硬度 (LS) 的动态变化。在开始治疗之前对患者进行评估，并每年进行一次随访。肝脏硬度测量 (LSM) 每年进行一次，每次测量获得 10 个有效的 LSM。可靠的 LSM 定义为 10 次测量的中值，四分位距/中值 (IQR/M) ≤ 30%。在随访期间观察到肝脏硬度值显着降低(p＜0.001)。在肝硬化患者中，仅一年后 LSM 显着下降，24.6 ± 4.3 kPa vs. 13.5 ± 4.2 kPa (p = 0.007)，而非肝硬化患者的下降不显着，7.31 ± 3.62 vs. 6.80 ± 2.41 (p = 0.27)。最初转氨酶较高的患者肝硬度降低更为显着。在治疗的第一年，73.5% 的患者实现了无法检测的病毒载量，第二年为 82.7%，第三年为 90.8%。总之，我们的研究表明，在头两年接受抗 HBV 治疗的慢性乙型肝炎患者中，TE 可降低肝脏硬度。它可以用作接受 NUC 治疗的患者的随访方法。

关键词：FibroScan；肝脏硬度的动态变化；乙型肝炎病毒;核苷（酸）类似物；口服抗病毒治疗；瞬态弹性成像。

StephenW

Dynamic Changes in Liver Stiffness in Patients with Chronic Hepatitis B Undergoing Antiviral Therapy
Alin Lazar  1 , Ioan Sporea  1 , Alexandru Popa  1 , Raluca Lupusoru  2 , Diana Gherhardt  1 , Ruxandra Mare  1 , Alexandru Apostu  3 , Madalina Hnatiuc  1 , Roxana Șirli  1
Affiliations
Affiliations

    1
    Division of Gastroenterology and Hepatology, Center for Advanced Research in Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
    2
    Center for Modeling Biological Systems and Data Analysis, Department of Functional Sciences, Faculty of Medicine, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
    3
    Department of Cardiology, Division of Internal Outpatient Medicine, Prevention and Cardiovascular Recovery, Advanced Research Center of the Institute for Cardiovascular Diseases, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timisoara, Romania.

    PMID: 36359490 DOI: 10.3390/diagnostics12112646

Abstract

This is a retrospective single-center study that included 87 subjects. All subjects had chronic hepatitis B or HBV cirrhosis and underwent nucleos(t)ide analogs (NUC) treatment for more than one year. The study aimed to evaluate the dynamic changes in liver stiffness (LS) measured by transient elastography (TE) during a median interval of 64 months. Patients were assessed prior to starting therapy and followed up annually. Liver stiffness measurements (LSM) were performed annually, and ten valid LSMs were obtained in each session. Reliable LSMs were defined as the median value of 10 measurements with Interquartile range/median (IQR/M) ≤30%. A significant decrease in liver stiffness values (p < 0.001) was observed during follow-up. In patients with liver cirrhosis, the LSMs decreased significantly after only one year, 24.6 ± 4.3 kPa vs. 13.5 ± 4.2 kPa (p = 0.007), whereas the decrease in non-cirrhotic patients was not significant, 7.31 ± 3.62 vs. 6.80 ± 2.41 (p = 0.27). Liver stiffness decrease was more significant in patients with initially higher transaminases. Undetectable viral load was achieved in 73.5% of patients in year one, 82.7% in year two, and 90.8% in year three of treatment. In conclusion, our study reveals a decrease in liver stiffness by TE in patients with chronic hepatitis B when undergoing anti-HBV therapy in the first two years. It can be used as a method for follow-up in patients undergoing NUC therapy.

Keywords: FibroScan; dynamic changes in liver stiffness; hepatitis B virus; nucleos(t)ide analogues; oral antiviral therapy; transient elastography.

StephenW

https://www.mdpi.com/2075-4418/12/11/2646/pdf?version=1667222855