Interpretation of liver stiffness measurement-based approach for the monitoring of hepatitis B patients with antiviral therapy: A 2-year prospective study
单位：[1]State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou, China[2]Department of Infectious Diseases, Ruijin Hospital, Jiaotong University School of Medicine, Shanghai, China[3]Department of Infectious Diseases, Xiangya Hospital, Central South University, Changsha, China[4]Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China华中科技大学同济医学院附属同济医院[5]Department of Hepatology, The First Hospital, Jilin University, Changchun, China[6]Department of Infectious Diseases, Tangdu Hospital, Xi’an, China[7]Ji’nan Infectious Diseases Hospital, Ji’nan, China[8]Beijing Ditan Hospital, Beijing, China[9]Department of Infectious Diseases, First Hospital of Peking University, Beijing, China[10]Hepatology Unit, Peking University People’s Hospital, Beijing, China[11]8th People’s Hospital, Guangzhou, China[12]Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China[13]Department of Infectious Diseases, Changhai Hospital, Shanghai, China[14]Beijing Youan Hospital, Beijing, China[15]Department of Infectious Diseases, West China Hospital, Chengdu, China四川大学华西医院[16]Department of Infectious Diseases, Zhejiang University 1st Affiliated Hospital, Hangzhou, China浙江大学医学院附属第一医院[17]Department of Infectious Diseases, Shengjing Hospital of China Medical University, Shenyang, China中国医科大学附属盛京医院[18]6th People’s Hospital, Hangzhou, China[19]Department of Infectious Diseases, The second Affiliated Hospital, Chongqing Medical University, Chongqing, China[20]Department of Infectious Diseases, 81st PLA Hospital, Nanjing, China[21]302nd PLA Hospital, Beijing, China[22]Department of Infectious Diseases, Sun Yat-Sen University 3rd Affiliated Hospital, Guangzhou, China中山大学附属第三医院[23]Department of Infectious Diseases, 85th PLA Hospital, Shanghai, China[24]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China临床科室国家中心肝病分中心首都医科大学附属北京友谊医院[25]Guangdong Provincial Research Center for Liver Fibrosis, Guangzhou, China
Liver biopsy is not routinely performed in treated chronic hepatitis B. Liver stiffness measurement has been validated for noninvasive liver fibrosis assessment in pretreatment chronic hepatitis B but has not been assessed for fibrosis monitoring during antiviral therapy. Liver stiffness was systemically monitored by Fibroscan((R)) every 6months in a cohort of patients with hepatitis B receiving antiviral therapy and compared with liver biopsies at baseline and week 104. A total of 534 hepatitis B e antigen-positive treatment-naive patients receiving telbivudine-based therapy with qualified liver stiffness measurement at baseline and week 104 were analyzed, 164 of which had adequate paired liver biopsies. Liver stiffness decreased rapidly (-2.2 kPa/24weeks) in parallel with alanine aminotransferase (ALT) from 8.6 (2.6-49.5) kPa at baseline to 6.1 (2.2-37.4) kPa at week 24. Interestingly, liver stiffness decreased slowly (-0.3 kPa/24weeks) but continually from week 24 to week 104 (6.1 vs 5.3 kPa, P<.001) while ALT levels remained stable within the normal range. More importantly, liver stiffness declined significantly irrespective of baseline ALT levels and liver necroinflammation grades. From baseline to week 104, the proportion of patients with no or mild fibrosis (Ishak, 0-2) increased from 74.4% (122/164) to 93.9% (154/164). Multivariate analysis revealed that percentage decline of 52-week liver stiffness from baseline was independently associated with 104-week liver fibrosis regression (odds ratio, 3.742; P=.016). Early decline of 52-week liver stiffness from baseline may reflect the remission of both liver inflammation and fibrosis and was predictive of 104-week fibrosis regression in treated patients with chronic hepatitis B.
基金：
National Science and Technology Major Project [2017ZX10202202]; Guangzhou Science and Technology Plan Project [201607020019, 201604020002]
第一作者单位：[1]State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou, China
共同第一作者：
通讯作者：
通讯机构：[1]State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou, China[24]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China[25]Guangdong Provincial Research Center for Liver Fibrosis, Guangzhou, China[*1]Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou, China[*2]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
推荐引用方式(GB/T 7714)：
X. Liang,Q. Xie,D. Tan,et al.Interpretation of liver stiffness measurement-based approach for the monitoring of hepatitis B patients with antiviral therapy: A 2-year prospective study[J].JOURNAL of VIRAL HEPATITIS.2018,25(3):296-305.doi:10.1111/jvh.12814.
APA：
X. Liang,Q. Xie,D. Tan,Q. Ning,J. Niu...&J. Hou.(2018).Interpretation of liver stiffness measurement-based approach for the monitoring of hepatitis B patients with antiviral therapy: A 2-year prospective study.JOURNAL of VIRAL HEPATITIS,25,(3)
MLA：
X. Liang,et al."Interpretation of liver stiffness measurement-based approach for the monitoring of hepatitis B patients with antiviral therapy: A 2-year prospective study".JOURNAL of VIRAL HEPATITIS 25..3(2018):296-305
