BARCELONA — Transient elastography was useful for measuring liver stiffness and change in liver inflammation and fibrosis in patients with hepatitis B virus infection on antiviral therapy, according to findings presented here.
“The use of liver stiffness measurement to monitor liver fibrosis dynamics has not been thoroughly evaluated during antiviral therapy. Our objective was to evaluate the kinetics of liver stiffness measurement values during antiviral therapy,” Jian Sun, MD, PhD, associate director of the department of infectious diseases and hepatology unit, Nanfang Hospital, Southern Medical University, China, said during his presentation in a general session.
Sun and colleagues evaluated 606 treatment-naive patients with chronic HBV and enrolled 599 to receive treatment with Tyzeka (telbivudine, Novartis) combined with Hepsera (adefovir, Gilead Sciences) or telbivudine alone for up to 5 years. Liver stiffness measurement was performed using FibroScan (transient elastography, Echosens, France) at 24 weeks during the 5-year antiviral treatment.
A majority of patients (n = 306) had qualified paired liver biopsies (at baseline and 104 weeks) and available liver stiffness measurement data and were included in final analysis. During 5-year antiviral treatment, liver stiffness measurement decreased from 8.5 (2.6-49.5) kPa at baseline to 6.1 (2.2-37.4) kPa at 24 weeks, and then decreased again to 4.9 (2.3-19.6) kPa at 260 weeks.
“The kinetics of liver stiffness measurement decreased during long-term antiviral therapy with bi-phase pattern, which may mainly reflect the resolution of inflammation during the first phase, and the regression of fibrosis during the second phase,” Sun said.
From baseline to 104 weeks, liver biopsy evaluation indicated the proportion of patients with mild or no evidence of necroinflammation increased from 29.7% (n = 103) to 77.2% (n = 268). The amount of patients with no or mild fibrosis increased from 29.1% (n = 101) to 66% (n = 229).
Through multivariate logistic regression analysis, researchers found liver stiffness measurement values at 24 and 52 weeks were independently associated with liver necroinflammation at 104 weeks (OR = 1.889; P = .014) and fibrosis (OR = 3.002; P = .023).
Sun concluded: “With antiviral treatment, liver stiffness measurement value decreased in majority of patients — a quick change followed by steady decrease. … Transient elastography is a useful tool for the evaluation of the change of liver inflammation and fibrosis during antiviral therapy.” – by Melinda Stevens
Sun J, et al. Abstract GS02. Presented at: International Liver Congress; April 13-17, 2016; Barcelona.
Disclosure: Sun reports no relevant financial disclosures. Please see the abstract for a list of all other researchers’ relevant financial disclosures.