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Optimal time for restoring the reliability of liver stiffness measurement in patients with chronic hepatitis B experiencing acute exacerbation

Authors
 Park, Hana  ;  Kim, Seung Up  ;  Kim, Darae  ;  Kim, Do Young  ;  Ahn, Sang Hoon  ;  Han, Kwang-Hyub  ;  Chon, Chae Yoon  ;  Park, Jun Yong 
Citation
 JOURNAL OF CLINICAL GASTROENTEROLOGY, Vol.46(7) : 602-607, 2012 
Journal Title
JOURNAL OF CLINICAL GASTROENTEROLOGY
ISSN
 0192-0790 
Issue Date
2012
MeSH
Adult ; Aged ; Alanine Transaminase/analysis* ; Elasticity Imaging Techniques* ; Female ; Hepatitis B, Chronic/diagnosis ; Hepatitis B, Chronic/pathology* ; Humans ; Liver/pathology ; Liver Cirrhosis/diagnosis* ; Liver Cirrhosis/pathology* ; Male ; Middle Aged ; Time Factors ; Young Adult
Keywords
chronic hepatitis B ; exacerbation ; FibroScan ; flare ; liver stiffness measurement ; transient elastography
Abstract
BACKGROUND/AIMS: Liver stiffness measurement (LSM) using transient elastography (FibroScan) is influenced by major changes in aminotransferase. We aimed to determine the optimal time for restoring the reliability of LSM for assessing liver fibrosis in patients with chronic hepatitis B experiencing acute exacerbation.

METHODS: Twenty-one patients with acute exacerbation of chronic hepatitis B [alanine aminotransferase (ALT)>5× upper limit of normal (ULN)] were prospectively recruited. Serial LSM and biochemical tests were performed at the time of admission and after 1, 3, 6, 9, and 12 months. The ULN of ALT was defined as 40 IU/L. The cutoff LSM value for cirrhosis was defined as 10.3 kPa.

RESULTS: The median age (9 male) was 49 years. The median ALT and LSM in the baseline were 522 IU/L and 15.1 kPa, respectively. Three months after acute exacerbation, ALT had decreased significantly below 2× ULN and stabilized (median: 522, 43, 21, 19, 18, and 16 IU/L at baseline, 1, 3, 6, 9, and 12 mo, respectively). However, LSM needed 3 more months (6 mo after exacerbation) for stabilization (median: 15.1, 10.0, 7.4, 7.1, 6.3, and 5.8 kPa at baseline, 1, 3, 6, 9, and 12 mo, respectively).

CONCLUSIONS: LSM should be postponed for at least 3 months after stabilization of ALT below 2× ULN to restore the reliability of LSM in assessing liver fibrosis.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00004836-201208000-00014&LSLINK=80&D=ovft
DOI
22772739
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Da Rae(김다래)
Kim, Do Young(김도영)
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
Park, Ha Na(박하나)
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Chon, Chae Yoon(전재윤)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90686
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