Lazar Alin, Sporea Ioan, Popa Alexandru, Lupusoru Raluca, Gherhardt Diana, Mare Ruxandra, Apostu Alexandru, Hnatiuc Madalina, Șirli Roxana
Division of Gastroenterology and Hepatology, Center for Advanced Research in Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Center for Modeling Biological Systems and Data Analysis, Department of Functional Sciences, Faculty of Medicine, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Diagnostics (Basel). 2022 Oct 31;12(11):2646. doi: 10.3390/diagnostics12112646.
This is a retrospective single-center study that included 87 subjects. All subjects had chronic hepatitis B or HBV cirrhosis and underwent nucleos(t)ide analogs (NUC) treatment for more than one year. The study aimed to evaluate the dynamic changes in liver stiffness (LS) measured by transient elastography (TE) during a median interval of 64 months. Patients were assessed prior to starting therapy and followed up annually. Liver stiffness measurements (LSM) were performed annually, and ten valid LSMs were obtained in each session. Reliable LSMs were defined as the median value of 10 measurements with Interquartile range/median (IQR/M) ≤ 30%. A significant decrease in liver stiffness values (p < 0.001) was observed during follow-up. In patients with liver cirrhosis, the LSMs decreased significantly after only one year, 24.6 ± 4.3 kPa vs. 13.5 ± 4.2 kPa (p = 0.007), whereas the decrease in non-cirrhotic patients was not significant, 7.31 ± 3.62 vs. 6.80 ± 2.41 (p = 0.27). Liver stiffness decrease was more significant in patients with initially higher transaminases. Undetectable viral load was achieved in 73.5% of patients in year one, 82.7% in year two, and 90.8% in year three of treatment. In conclusion, our study reveals a decrease in liver stiffness by TE in patients with chronic hepatitis B when undergoing anti-HBV therapy in the first two years. It can be used as a method for follow-up in patients undergoing NUC therapy.
这是一项回顾性单中心研究，纳入了87名受试者。所有受试者均患有慢性乙型肝炎或乙肝肝硬化，并接受了核苷（酸）类似物（NUC）治疗超过一年。该研究旨在评估在中位时间间隔64个月期间，通过瞬时弹性成像（TE）测量的肝脏硬度（LS）的动态变化。患者在开始治疗前进行评估，并每年进行随访。每年进行肝脏硬度测量（LSM），每次获得10次有效的LSM。可靠的LSM定义为10次测量的中位数，四分位间距/中位数（IQR/M）≤30%。随访期间观察到肝脏硬度值显著下降（p<0.001）。在肝硬化患者中，仅一年后LSM就显著下降，从24.6±4.3 kPa降至13.5±4.2 kPa（p = 0.007），而非肝硬化患者的下降不显著，从7.31±3.62降至6.80±2.41（p = 0.27）。初始转氨酶较高的患者肝脏硬度下降更显著。治疗第一年73.5%的患者、第二年82.7%的患者和第三年90.8%的患者实现了病毒载量不可测。总之，我们的研究揭示了慢性乙型肝炎患者在接受抗乙肝治疗的前两年中，通过TE测量的肝脏硬度下降。它可作为接受NUC治疗患者的一种随访方法。
