Successful therapy with tenofovir disoproxil fumarate (TDF) in patients with chronic hepatitis B (CHB) does not guarantee amelioration of liver damage assessing by transient elastography. A retrospective - prospective multicenter study

• Published in: BMC gastroenterology 2024-04, Vol.24 (1), p.133-133, Article 133
• Main Authors: Kranidioti, Hariklia, Zisimopoulos, Konstantinos, Oikonomou, Theodora, Voulgaris, Theodoros, Siakavellas, Spyros, Agorastou, Polixeni, Deutsch, Melanie, Triantos, Christos, Goulis, Ioannis, Papatheodoridis, George, Manolakopoulos, Spilios
• Format: Article
• Language: English
• Subjects: Adult; Antiviral agents; Biopsy; BMI; Chronic hepatitis B; Diabetes; Elasticity Imaging Techniques; Fibrosis; Gastroenterology; Hepatitis B; Hepatitis B, Chronic - complications; Hepatitis B, Chronic - drug therapy; Humans; Hypertension; Internal medicine; Liver; Liver cancer; Liver cirrhosis; Liver Cirrhosis - diagnostic imaging; Liver stiffness; Metabolic disorders; Metabolic factors; Multivariate analysis; Prospective Studies; Remission (Medicine); Retrospective Studies; TDF; Tenofovir; Tenofovir - therapeutic use
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/s12876-024-03200-3

Preventing disease progression and viral suppression are the main goals of antiviral therapy in chronic hepatitis B (CHB). Liver stiffness measurement (LSM) by transient elastography is a reliable non-invasive method to assess liver fibrosis in patients with CHB. Our aim was to explore factors that may affect changes in LSMs during long term tenofovir (TDF) monotherapy in a well characterized cohort of patients with compensated CHB. We analyzed serial LSMs in 103 adult patients with CHB who were on TDF monotherapy and had at least three LSMs over a period of 90 months. Twenty-five (24%) patients had advanced fibrosis at baseline. A significant decline in mean LSM between baseline and last visit (8.7 ± 6.2 kPa vs. 6.7 ± 3.3, p = 10 ) was observed. Twenty-four (23%) patients had progression of liver fibrosis with mean increase in liver stiffness of 2.8 kPa (range: 0.2-10.2 kPa). Multivariate analysis showed that BMI ≥ 25 (OR, 0.014; 95% CI, 0.001-0.157; p = 0.001) and advanced fibrosis (OR, 5.169; 95% CI, 1.240-21.540; p = 0.024) were independently associated with a fibrosis regression of > 30% of liver stiffness compared to baseline value. In CHB patients TDF monotherapy resulted in liver fibrosis regression, especially in patients with advanced fibrosis. Despite the successful antiviral effect of TDF, 1 out of 4 patients had liver fibrosis progression. Obesity and advanced fibrosis at baseline were independently associated with significant liver fibrosis regression.