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Liver stiffness measurement may predict liver-related events in patients with chronic HBV

Liver stiffness measurements obtained through transient elastography may predict the development of liver-related events such as decompensation and carcinoma among patients with chronic hepatitis B, according to recent results.

Researchers evaluated 128 patients with chronic hepatitis B (CHB), histologically advanced fibrosis and high viral loads and had undergone liver biopsy (LB) and liver stiffness measurement (LSM) using FibroScan transient elastography. Incidences of liver-related events (LRE) such as hepatic decompensation and hepatocellular carcinoma were recorded in order to determine whether LSM can predict the development of these events.

The median LSM value across the cohort was 12.9 kPa (4.4-57.1). A median follow-up of 27.8 (12.6-61.6) months was conducted, during which 19 patients (14.8%) developed LRE, including five cases of hepatic decompensation, 13 hepatocellular carcinomas, and one patient experiencing both. The decompensation cases included two instances of variceal bleeding, two of ascites development and two of hepatic encephalopathy.

Among patients without LRE development, the mean LSM value was 11.8 kPa (4.4-48.0) compared with 21.1 (7.8-57.1) among patients with LREs (P=.011). A multivariate analysis indicated that LSM independently predicted the incidence of LREs (HR=1.038; 95% CI, 1.002-1.081), along with age. Investigators established 19 kPa as the optimal cutoff LSM value to stratify the cohort into two groups, and found that the 27 participants with values greater than 19 kPa were found to be at greater risk for LRE development compared with the 101 patients with values equal to or less than 19 kPa (HR=7.176; 95% CI, 2.257-22.812).

Several participants (n=114) received a second LSM before any LRE development at a 13.1-month (range 3.8-51.6 months) median interval. Ten of these participants (8.8%) developed LREs, but no statistical significance was found in the change in LSM values between the two screenings (P>.05).

“Our data suggest that LSM can be a useful predictor of LRE development in CHB patients showing histologically advanced liver fibrosis,” the researchers wrote. “However, this finding should be confirmed in CHB patients without baseline histologic data before the widespread application of LSM to all patients undergoing antiviral treatment.”