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Improvement of Liver Fibrosis after Long-Term Antiviral Therapy Assessed by Fibroscan in Chronic Hepatitis B Patients With Advanced Fibrosis

 Young Eun Chon  ;  Jun Yong Park  ;  Sung-Min Myoung  ;  Kyu Sik Jung  ;  Beom Kyung Kim  ;  Seung Up Kim  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Kwang-Hyub Han 
 American Journal of Gastroenterology, Vol.112(6) : 882-891, 2017 
Journal Title
 American Journal of Gastroenterology 
Issue Date
Adult ; Antiviral Agents/therapeutic use* ; Aspartate Aminotransferases/blood ; Carcinoma, Hepatocellular/virology* ; DNA, Viral/blood* ; Elasticity Imaging Techniques* ; Female ; Follow-Up Studies ; Guanine/analogs & derivatives ; Guanine/therapeutic use ; Hepatitis B virus* ; Hepatitis B, Chronic/blood ; Hepatitis B, Chronic/complications ; Hepatitis B, Chronic/drug therapy* ; Humans ; Lamivudine/therapeutic use ; Liver Cirrhosis/blood ; Liver Cirrhosis/diagnostic imaging* ; Liver Cirrhosis/virology ; Liver Neoplasms/virology* ; Male ; Middle Aged ; Platelet Count ; Predictive Value of Tests ; Prospective Studies ; Severity of Illness Index
OBJECTIVES: Performing repeated liver biopsies to assess the improvement of liver fibrosis is impractical. The purpose of this prospective cohort study was to assess the improvement of liver fibrosis during antiviral treatment by serial liver stiffness (LS) measurement using Fibroscan in chronic hepatitis B (CHB) patients with advanced fibrosis. METHODS: Nucleos(t)ide analog-naive CHB patients with advanced fibrosis in histological findings (stage ≥F3), high viral load (hepatitis B virus DNA ≥2,000 IU/ml), and normal liver enzyme levels (<2 × upper normal limit) before starting antiviral treatment were included in this study. LS measurement was performed at baseline and annually for 5 years during antiviral treatment. Five-year fibrosis improvement was defined as LS value <7.2 kPa (<F3) at year 5. RESULTS: The mean LS value of 120 patients significantly decreased over time (14.5 kPa at baseline; 11.3 kPa at year 1; 9.6 kPa at year 2; 9.3 kPa at year 3; 8.6 kPa at year 4; and 8.3 kPa at year 5). Multivariate analysis showed that baseline LS value was the only predictor of 5-year fibrosis improvement (odds ratio, 0.907; 95% confidence interval, 0.838-0.980; P=0.014). Patients with low baseline LS values (<12.0 kPa) had a greater probability of experiencing significant fibrosis improvement than those with high baseline LS values (≥12.0 kPa) (81.5% vs. 29.0%, P<0.001). CONCLUSIONS: In CHB patients with advanced fibrosis receiving antiviral treatment, annual LS measurement revealed that fibrosis improvement slows but continues during treatment. Low LS value (<12.0 kPa) at baseline was a significant predictor for 5-year fibrosis improvement.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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