Liu Feng, Sun Yameng, Tai Dean, Ren Yayun, Chng Elaine L K, Wee Aileen, Bedossa Pierre, Huang Rui, Wang Jian, Wei Lai, You Hong, Rao Huiying
Peking University People's Hospital, Peking University Hepatology Institute, Infectious Disease and Hepatology Center of Peking University People's Hospital, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Beijing 100044, China.
Liver Research Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Road, Xi-Cheng District, Beijing 100050, China.
Diagnostics (Basel). 2024 Aug 22;14(16):1837. doi: 10.3390/diagnostics14161837.
This study aimed to understand the dynamic changes in fibrosis and its relationship with the evaluation of post-treatment viral hepatitis using qFibrosis. A total of 158 paired pre- and post-treatment liver samples from patients with chronic hepatitis B (CHB; = 100) and C (CHC; = 58) were examined. qFibrosis was employed with artificial intelligence (AI) to analyze the fibrosis dynamics in the portal tract (PT), periportal (PP), midzonal, pericentral, and central vein (CV) regions. All patients with CHB achieved a virological response after 78 weeks of treatment, whereas patients with CHC achieved a sustained viral response after 24 weeks. For patients initially staged as F5/6 (Ishak system) at baseline, the post-treatment cases exhibited a significant reduction in the collagen proportionate area (CPA) (25-69%) and number of collagen strings (#string) (9-72%) across all regions. In contrast, those initially staged as F3/4 at baseline showed a similar CPA and #string trend at 24 weeks. For regression patients, 27 parameters (25 in the CV region) in patients staged as F3/4 and 15 parameters (three in the PT and 12 in the PP regions) in those staged as F5/6 showed significant differences between the CHB and CHC groups at baseline. Following successful antiviral treatment, the pre- and post-treatment liver samples provided quantitative evidence of the heterogeneity of fibrotic features. qFibrosis has the potential to provide new insights into the characteristics of fibrosis regression in both patients with CHB and CHC as early as 24 weeks after antiviral therapy.
本研究旨在了解纤维化的动态变化及其与使用qFibrosis评估治疗后病毒性肝炎的关系。共检测了158对慢性乙型肝炎（CHB；n = 100）和丙型肝炎（CHC；n = 58）患者治疗前后的肝脏样本。采用qFibrosis结合人工智能（AI）分析汇管区（PT）、门周（PP）、中区、中央周围和中央静脉（CV）区域的纤维化动态变化。所有CHB患者在治疗78周后实现病毒学应答，而CHC患者在24周后实现持续病毒学应答。对于基线时初始分期为F5/6（Ishak系统）的患者，治疗后的病例在所有区域的胶原相对面积（CPA）（25% - 69%）和胶原束数量（#束）（9% - 72%）均显著降低。相比之下，基线时初始分期为F3/4的患者在24周时CPA和#束呈现相似趋势。对于病情好转的患者，基线时F3/4分期患者的27个参数（CV区域25个）和F5/6分期患者的15个参数（PT区域3个，PP区域12个）在CHB和CHC组之间存在显著差异。抗病毒治疗成功后，治疗前后的肝脏样本为纤维化特征的异质性提供了定量证据。qFibrosis有潜力早在抗病毒治疗24周后就为CHB和CHC患者纤维化消退的特征提供新的见解。
