Erschienen in:
15.01.2018 | Original Paper
Influence of antiviral therapy on the liver stiffness in chronic HBV hepatitis
verfasst von:
Luca Rinaldi, Antonio Ascione, Vincenzo Messina, Valerio Rosato, Giovanna Valente, Vincenzo Sangiovanni, Rosa Zampino, Aldo Marrone, Luca Fontanella, Nicolina de Rosa, Pasquale Orabona, Carmela Buonomo, Antonio Chirianni, Luigi Elio Adinolfi, Guido Piai
Erschienen in:
Infection
|
Ausgabe 2/2018
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Abstract
Purpose
The aim of this study was to evaluate the effects of antiviral therapy on liver stiffness measurement (LSM).
Methods
Two hundred HBV patients were enrolled from four hospital centers in southern Italy; median age was 50.7 (25–75) males were 68%; 171 patients underwent to liver biopsy and 200 patients had LSM at baseline and 189 at the end of follow-up. One hundred and forty-nine patients were treated with nucleos(t)ide analogs, while 51 patients were untreated. The cutoffs of the LSM, related to the fibrosis stages, were as follows: non-advanced fibrosis ≤ 8.1 kPa and advanced fibrosis ≥ 8.2 Kpa.
Results
At baseline, the median value of LSM was 14.1 kPa for advanced fibrosis/cirrhosis and 6.9 kPa for non-advanced fibrosis. LSM was performed at 24 months from the start of therapy. The treated patients (68% received Entecavir and 32% Tenofovir) showed a decrease in liver stiffness measurement of 1.5 kPa (p < 0.001) in non-advanced fibrosis and of 6 kPa (p < 0.001) in advanced fibrosis/cirrhosis. In the patients not undergoing antiviral treatment, no statistically significant change of the LSM was observed (p = 0.26). A logistic binary regression model showed that the only independent factor associated with a significant change in the LSM was the liver stiffness value at baseline (odd ratio 2.855; 95% CI 1.456–5.788; (p = 0.007).
Conclusion
Long-term antiviral therapy induced a significant reduction of liver stiffness measurement and this result may be related to the reduction of liver fibrosis.