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(40): 6154-62, 2008 Oct 28.
Article
em En
| MEDLINE
| ID: mdl-18985805
ABSTRACT
AIM:
To investigate the usefulness of transient elastography by Fibroscan (FS), a rapid non-invasive technique to evaluate liver fibrosis, in the management of chronic hepatitis B virus (HBV) carriers.METHODS:
In 297 consecutive HBV carriers, we studied the correlation between liver stiffness (LS), stage of liver disease and other factors potentially influencing FS measurements. In 87 chronic hepatitis B (CHB) patients, we monitored the FS variations according to the spontaneous or treatment-induced variations of biochemical activity during follow-up.RESULTS:
FS values were 12.3 +/- 3.3 kPa in acute hepatitis, 10.3 +/- 8.8 kPa in chronic hepatitis, 4.3 +/- 1.0 kPa in inactive carriers and 4.6 +/- 1.2 kPa in blood donors. We identified the cut-offs of 7.5 and 11.8 kPa for the diagnosis of fibrosis >or= S3 and cirrhosis respectively, showing 93.9% and 86.5% sensitivity, 88.5% and 96.3% specificity, 76.7% and 86.7% positive predictive value (PPV), 97.3% and 96.3% negative predictive value (NPV) and 90.1% and 94.2% diagnostic accuracy. At multivariate analysis in 171 untreated carriers, fibrosis stage (t = 13.187, P < 0.001), active vs inactive HBV infection (t = 6.437, P < 0.001), alanine aminotransferase (ALT) (t = 4.740, P < 0.001) and HBV-DNA levels (t = or-2.046, P = 0.042) were independently associated with FS. Necroinflammation score (t = 2.158, > 10/18 vsCONCLUSION:
FS is a non-invasive tool to monitor liver disease in chronic HBV carriers, provided that the pattern of biochemical activity is taken into account. In the inactive carrier, it identifies non-HBV-related causes of liver damage and transient reactivations. In CHB patients, it may warrant a more appropriate timing of control liver biopsies.
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Base de dados:
MEDLINE
Assunto principal:
Portador Sadio
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Hepatite B Crônica
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Alanina Transaminase
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Ensaios Enzimáticos Clínicos
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Técnicas de Imagem por Elasticidade
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Hepatite B
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Fígado
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Cirrose Hepática
Idioma:
En
Ano de publicação:
2008
Tipo de documento:
Article