The usefulness of transient elastography in the assessment of patients with HBeAg-negative chronic hepatitis B virus infection
| Autor: | H. Kranidioti, Sofia Adamidi, A. Katoglou, Aikaterini Margariti, Georgia Kafiri, Maria-Vasiliki Papageorgiou, Spilios Manolakopoulos, Dimitrios G. Pectasides, Melanie Deutsch, G. Kontos, George V. Papatheodoridis |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Cirrhosis Viremia Severity of Illness Index Gastroenterology Virus Hepatitis B Chronic Fibrosis Virology Internal medicine Biopsy medicine Humans Hepatitis B e Antigens Aged Hepatology medicine.diagnostic_test business.industry virus diseases Middle Aged medicine.disease digestive system diseases Surgery Infectious Diseases Liver biopsy Elasticity Imaging Techniques Female Elastography business Transient elastography |
| Zdroj: | Journal of Viral Hepatitis. 21:517-524 |
| ISSN: | 1352-0504 |
| DOI: | 10.1111/jvh.12176 |
| Popis: | 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-DNA2000 (n = 139) or 2000-19 999 IU/mL (n = 43) and 175 patients with chronic hepatitis B (CHB). In carriers, HBV-DNA2000 and/or LSM6.5 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, P0.001) 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 LSM6.5 than ≤ 6.5 kPa. Moderate fibrosis (stages: 2-3) was detected in 0/10 carriers with only HBV-DNA2000 IU/mL, 2/10 (20%) carriers with only LSM6.5 and 5/10 (50%) carriers with both HBV-DNA2000 and LSM6.5 (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 LSM6.5 kPa and 50% of carriers with LSM6.5 kPa and HBV-DNA2000 IU/mL. |
| Databáze: | OpenAIRE |
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