Longitudinal assessment of liver stiffness by transient elastography for chronic hepatitis B patients treated with nucleoside analog

Aim: To evaluate the association between liver stiffness measured by transient elastography (FibroScan) and the efficacy of long-term nucleoside analog (NA) treatment for patients with chronic hepatitis B. Methods: Study 1: Forty-four chronic HBV patients had liver stiffness measured by FibroScan and underwent liver biopsy. Study 2: Group A: 22 patients started NA treatment at entry and FibroScan was done annually for 3years. Group B: 23 patients started NA treatment prior to pretreatment FibroScan measurement, and FibroScan was done for from 3 to 5years after the start of NA treatment. Results: Study 1: The FibroScan values were significantly correlated with fibrosis stage (r=0.672, P<0.0001). Optimal cutoff of FibroScan values were 6.1kPa for≥F1, 6.3kPa for≥F2, 8.9kPa for≥F3 and 12.0kPa for F4. Study 2: For Group A, the baseline median FibroScan value was 8.2kPa. FibroScan values significantly decreased annually for 3years after the start of NA treatment (6.4kPa, 5.8kPa and 5.3kPa at years 1, 2 and 3, respectively). For Group B, the FibroScan values did not significantly improve over the 3years after the start of NA treatment. Conclusions: Liver stiffness, measured by transient elastography, of chronic hepatitis B patients treated with NA showed a rapid decline in the first 3years followed by a more steady transition for from 3 to 5years irrespective of long term virological effect.