Τίτλος:
The usefulness of transient elastography in the assessment of patients
with HBeAg-negative chronic hepatitis B virus infection
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Histological severity is often mandatory for the management of
HBeAg-negative chronic HBV patients. We evaluated the performance of
transient elastography (TE) in this setting. We included 357 untreated
HBeAg-negative patients with >= 1 reliable liver stiffness measurement
(LSM-kPa) by TE: 182 inactive carriers with HBV-DNA < 2000 (n = 139) or
2000-19 999 IU/mL (n = 43) and 175 patients with chronic hepatitis B
(CHB). In carriers, HBV-DNA > 2000 and/or LSM > 6.5 were considered as
biopsy indications. LSMs did not differ between carriers with low and
high viremia, but were lower in carriers than in patients with CHB (5.8
+/- 1.7 vs 9.0 +/- 5.6, P < 0.001) offering moderate differentiation
between these two groups (AUROC: 0.705). LSMs did not change
significantly in carriers after 16 (12-24) months. In carriers with a
liver biopsy, Ishak’s staging scores were similar between cased with low
and high viremia but higher in cases with LSM > 6.5 than <= 6.5 kPa.
Moderate fibrosis (stages: 2-3) was detected in 0/10 carriers with only
HBV-DNA > 2000 IU/mL, 2/10 (20%) carriers with only LSM > 6.5 and 5/10
(50%) carriers with both HBV-DNA > 2000 and LSM > 6.5 (P = 0.009). In
patients with CHB, LSMs correlated significantly with grading and
staging scores and offered excellent accuracy for >= moderate, >= severe
fibrosis or cirrhosis (AUROC >= 0.919-0.950). TE can be helpful for the
noninvasive assessment of HBeAg-negative chronic HBV patients. In
conclusion, LSMs offer excellent accuracy for fibrosis severity in
HBeAg-negative patients with CHB and can identify carriers with high
risk of moderate fibrosis, which may be present in up to 35% of
carriers with LSM > 6.5 kPa and 50% of carriers with LSM > 6.5 kPa and
HBV-DNA > 2000 IU/mL.
Συγγραφείς:
Papatheodoridis, G. V.
Manolakopoulos, S.
Margariti, A. and
Papageorgiou, M. V.
Kranidioti, H.
Katoglou, A.
Kontos, G.
and Adamidi, S.
Kafiri, G.
Deutsch, M.
Pectasides, D.
Περιοδικό:
Journal of Viral Hepatitis
Λέξεις-κλειδιά:
chronic hepatitis B; elastography; HBV-DNA; inactive carriers; liver
biopsy
