Longitudinal change of liver stiffness by transient elestography in chronic hepatitis B patients treated with nucleos(t)ide analogue

SummaryBackgroundLiver stiffness measurement (LSM) by transient elastography is a non-invasive method to assess liver fibrosis. Decline in LSM value has been reported after antiviral treatment (AVT) using nucleos(t)ide analogues (NUCs) in chronic hepatitis B (CHB) patients, however, factors associated with changes in LSM during AVT remains unclear.MethodsA total of 76 CHB patients who received AVT with NUCs and had serial LSM (median duration: 16 months, range: 12 to 35 months) during AVT were analyzed. Complete virological response (CVR) was defined when hepatitis B virus DNA level was undetectable by real-time PCR assay (< 50 copies/mL).ResultsLSM value had significantly decreased after AVT with NUCs [median (quartile): 6.5 (4.7–9.2) to 5.3 (3.9–6.7), P < 0.001]. The median change of LSM value/year was −0.8 (range: −9.5∼4.9). The annual change of LSM value was associated with baseline total bilirubin levels, HBeAg status and achievement of CVR during follow-up in univariable analysis, and achievement of CVR during follow-up was an only independent factor associated with the annual change of LSM value [beta coefficients (95% confidence interval) = −0.29 (−2.81∼−0.26), P = 0.02]. The annual LSM change was significantly different between those who achieved and did not achieve CVR (median change: −1.08/year vs. 0.26/year, P < 0.01), and more patients with CVR had decrease in LSM value (89% (47/53) vs. 35% (8/23), P < 0.01).ConclusionsA significant decrease in LSM value was observed in CHB patients after AVT with NUCs. Achievement of CVR was significant factor associated with change in LSM value. Achieving CVR might be a key to decrease LSM value during AVT with NUCs.