The factor that improve liver stiffness in patients with chronic hepatitis B
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Background/Aims: Liver stiffness (LS) as assessed by transient elastography (TE) can change longitudinally in patients with chronic hepatitis B (CHB). The aim of this study was to identify the factors that improve LS. Methods: Between April 2007 and December 2012, 151 patients with CHB who underwent two TE procedures with an interval of about 2 years were enrolled. Ninety-six of the 151 patients were treated with nucleos(t)ide analogues [the antiviral therapy (+) group], while the remaining 55 patients were not [the antiviral therapy (–) group]. The two groups of patients were stratified according to whether they exhibited an improvement or a deterioration in LS during the study period (defined as an LS change of ≤0 or >0 kPa, respectively, over a 1-year period), and their data were compared. Results: No differences were observed between the antiviral therapy (+) and (–) groups with respect to either their clinical characteristics or their initial LS. The observed LS improvement was significantly greater in the antiviral therapy (+) group than in the antiviral therapy (–) group (–3.0 vs. 0.98 kPa, P=0.011). In the antiviral therapy (+) group, the initial LS was higher in the LS improvement group (n=63) than in the LS deterioration group (n=33; 7.9 vs. 4.8 kPa, P<0.001). However, there were no differences in any other clinical characteristic. In the antiviral therapy (–) group, the initial LS was also higher in the LS improvement group (n=29) than in the LS deterioration group (n=26; 8.3 vs. 6.5 kPa, P=0.021), with no differences in any other clinical characteristic. Conclusions: A higher initial LS was the only factor associated with LS improvement in patients with CHB in this study. (Clin Mol Hepatol 2015;21:32-40)
Abstract
Background/Aims: Liver stiffness (LS) as assessed by transient elastography (TE) can change longitudinally in patients with chronic hepatitis B (CHB). The aim of this study was to identify the factors that improve LS. Methods: Between April 2007 and December 2012, 151 patients with CHB who underwent two TE procedures with an interval of about 2 years were enrolled. Ninety-six of the 151 patients were treated with nucleos(t)ide analogues [the antiviral therapy (+) group], while the remaining 55 patients were not [the antiviral therapy (–) group]. The two groups of patients were stratified according to whether they exhibited an improvement or a deterioration in LS during the study period (defined as an LS change of ≤0 or >0 kPa, respectively, over a 1-year period), and their data were compared. Results: No differences were observed between the antiviral therapy (+) and (–) groups with respect to either their clinical characteristics or their initial LS. The observed LS improvement was significantly greater in the antiviral therapy (+) group than in the antiviral therapy (–) group (–3.0 vs. 0.98 kPa, P=0.011). In the antiviral therapy (+) group, the initial LS was higher in the LS improvement group (n=63) than in the LS deterioration group (n=33; 7.9 vs. 4.8 kPa, P<0.001). However, there were no differences in any other clinical characteristic. In the antiviral therapy (–) group, the initial LS was also higher in the LS improvement group (n=29) than in the LS deterioration group (n=26; 8.3 vs. 6.5 kPa, P=0.021), with no differences in any other clinical characteristic. Conclusions: A higher initial LS was the only factor associated with LS improvement in patients with CHB in this study. (Clin Mol Hepatol 2015;21:32-40)
참고문헌 (39)
- Kim SU, "Non-inva sive assessment of changes in liver fibrosis via liver stiffness measurement in patients with chronic hepatitis B : impact of antiviral treatment on fibrosis regression", Hepatol Int, 4, pp.673~680 (2010)
- Enomoto M, "Usefulness of transient elastography for assessment of liver fibrosis in chronic hepatitis B : Regression of liver stiffness during entecavir therapy", Hepatol Res, 40, pp.853~861 (2010)
- Arase Y, "Long-term outcome after hepatitis B surface antigen seroclearance in patients with chronic hepatitis B", Am J Med, 119(71), pp.e9~e16 (2006)
- Chen YC, "Prognosis following spontaneous HBsAg seroclearance in chronic hepatitis B patients with or without concurrent infection", Gastroenterology, 123, pp.1084~1089 (2002)
- Perrault J, "Liver biopsy : complications in 1000 inpatients and outpatients", Gastroenterology, 74, pp.103~106 (1978)
- Janes CH, "Outcome of patients hospitalized for complications after outpatient liver biopsy", Ann Intern Med, 118, pp.96~98 (1993)
- Rockey DC, "Noninvasive measures of liver fibrosis", Hepatology, 43(2 Suppl 1), pp.S113~S120 (2006)
- Halfon P, "Comparison of test performance profile for blood tests of liver fibrosis in chronic hepatitis C", J Hepatol, 46, pp.395~402 (2007)
- Yoshioka K, "Transient elastography : Applications and limitations", Hepatol Res, 38, pp.1063~1068 (2008)
- Castera L, "Non-invasive evaluation of liver fibrosis using transient elastography", J Hepatol, 48, pp.835~847 (2008)
- Sandrin L, "Transient elastography : a new noninvasive method for assessment of hepatic fibrosis", Ultrasound Med Biol, 29, pp.1705~1713 (2003)
- Zhang YG, "Assessment of hepatic fibrosis by transient elastography in patients with chronic hepatitis B", Pathol Int, 60, pp.284~290 (2010)
- Castera L, "Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C", Gastroenterology, 128, pp.343~350 (2005)
- Colletta C, "Value of two noninvasive methods to detect progression of fibrosis among HCV carriers with normal aminotransferases", Hepatology, 42, pp.838~845 (2005)
- Ziol M, "Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with chronic hepatitis C", Hepatology, 41, pp.48~54 (2005)
- Corpechot C, "Assessment of biliary fibrosis by transient elastography in patients with PBC and PSC", Hepatology, 43, pp.1118~1124 (2006)
- Fung J, "Significant changes in liver stiffness measurements in patients with chronic hepatitis B: 3-year follow-up study", J Viral Hepat, 18, pp.e200~e205 (2011)
- Suk KT, "Revision and update on clinical practice guideline for liver cirrhosis", Korean J Hepatol, 18, pp.1~21 (2012)
- Poynard T, "Impact of pegylated interferon alfa-2b and ribavirin on liver fibrosis in patients with chronic hepatitis C", Gastroenterology, 122, pp.1303~1313 (2002)
- George SL, "Clinical, virologic, histologic, and biochemical outcomes after successful HCV therapy: a 5-year follow-up of 150 patients", Hepatology, 49, pp.729~738 (2009)
- Veldt BJ, "Sustained virologic response and clinical outcomes in patients with chronic hepatitis C and advanced fibrosis", Ann Intern Med, 147, pp.677~684 (2007)
- Bruno S, "Sustained virological response to interferon-alpha is associated with improved outcome in HCV-related cirrhosis : a retrospective study", Hepatology, 45, pp.579~587 (2007)
- Maylin S, "Eradication of hepatitis C virus in patients successfully treated for chronic hepatitis C", Gastroenterology 200, 135, pp.821~829 (2008)
- Arima Y, "Reduction of liver stiffness by interferon treatment in the patients with chronic hepatitis C", Hepatol Res, 40, pp.383~392 (2010)
- Wang JH, "Liver stiffness decrease after effective antiviral therapy in patients with chronic hepatitis C : Longitudinal study using FibroScan", J Gastroenterol Hepatol, 25, pp.964~969 (2010)
- "EASL clinical practice guidelines: Management of chronic hepatitis B virus infection", J Hepatol, 57, pp.167~185 (2012)
- Dienstag JL, "Histological outcome during long-term lamivudine therapy", Gastroenterology, 124, pp.105~117 (2003)
- Rizzetto M, "Extended lamivudine treatment in patients with HBeAg-negative chronic hepatitis B", J Hepatol, 42, pp.173~179 (2005)
- Chang TT, "Long-term entecavir therapy results in the reversal of fibrosis", cirrhosis and continued histological improvement in patients with chronic hepatitis B, 2010, pp.52, 886~893
- Schiff ER, "Longterm treatment with entecavir induces reversal of advanced fibrosis or cirrhosis in patients with chronic hepatitis B", Clin Gastroenterol Hepatol, 9, pp.274~276 (2011)
- Marcellin P, "Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B : a 5-year open-label follow-up study", Lancet, 381, pp.468~475 (2013)
- Coco B, "Transient elastography : a new surrogate marker of liver fibrosis influenced by major changes of transaminases", J Viral Hepat, 14, pp.360~369 (2007)
- Oliveri F, "Liver stiffness in the hepatitis B virus carrier : a non-invasive marker of liver disease influenced by the pattern of transaminases", World J Gastroenterol, 14, pp.6154~6162 (2008)
- Arena U, "Acute viral hepatitis increases liver stiffness values measured by transient elastography", Hepatology, 47, pp.380~384 (2008)
- Sagir A, "Transient elastography is unreliable for detection of cirrhosis in patients with acute liver damage", Hepatology, 47, pp.592~595 (2008)
- Roulot D, "Liver stiffness values in apparently healthy subjects : influence of gender and metabolic syndrome", J Hepatol, 48, pp.606~613 (2008)
- 배락천, "만성 간질환 환자에서 순간탄성측정법(transient elastography, FibroscanⓇ)에 의한 간탄력도에 영향을 줄 수 있는 임상요소", Clinical and Molecular Hepatology, 16(2), pp.123~130 (2010), 대한간학회
- Seo YS, "Transient elastography, true or false?", Korean J Hepatol, 15, pp.431~437 (2009)
- Martinez SM, "Longitudinal liver stiffness assessment in patients with chronic hepatitis C undergoing antiviral therapy", PloS one, 7, pp.e47715~ (2012)
