Liver elastography can predict degree of advanced fibrosis for autoimmune hepatitis in biochemical remission

Background and Aim The aim was to analyze the concordance of liver stiffness measurement (LSM) either by transient elastography (TE) or ARFI with liver biopsy in autoimmune hepatitis (AIH) patients with biochemical remission and to identify those with histological remission. Liver biopsy is still th...

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Published in:JGH open 2023-04, Vol.7 (4), p.272-277
Main Authors: Paranaguá‐Vezozzo, Denise Cerqueira, Benedita Terrabuio, Débora Raquel, Reinoso‐Pereira, Gleicy Luz, Moutinho, Renata, Kioko Ono, Suzane, Walwyn Salas, Veronica, Dias França, Joao Italo, Alves, Venâncio Avancini Ferreira, Cançado, Eduardo Luiz Rachid, Carrilho, Flair José
Format: Article
Language:English
Subjects:
acoustic radiation force imaging
autoimmune hepatitis
Biopsy
Blood
Body mass index
Cholangitis
Hepatitis
High density lipoprotein
Infections
Laboratories
liver biopsy
Liver cancer
Liver diseases
liver fibrosis
METAVIR score
Original
Remission (Medicine)
Smooth muscle
transient elastography
Ultrasonic imaging
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Summary:Background and Aim The aim was to analyze the concordance of liver stiffness measurement (LSM) either by transient elastography (TE) or ARFI with liver biopsy in autoimmune hepatitis (AIH) patients with biochemical remission and to identify those with histological remission. Liver biopsy is still the golden standard for AIH diagnosis. However, it is an invasive procedure and these patients, most of the time, require many biopsies, so it would be valuable to search for noninvasive method that could select all these patients and keep under observation. Methods Thirty‐three patients with AIH were submitted for liver biopsy to evaluate histological remission after at least 18 months of normal aminotransferases. The efficiency of LSM and fibrosis stages was tested by a receiver operating characteristic curve analysis (AUROC). Results One patient (3%) was F0, 6 (18.2%) were F1, 8 (24.2%) were F2, 10 (30.3%) were F3, and 8 (24.2%) were F4, according to METAVIR. Thirteen of thirty‐three (39.4%) patients did not achieve histological remission. AUROC for F4 stage was 0.83 (IC: 0.76–0.99) for TE and 0.78 (IC: 0.65–0.95) for ARFI. Optimal LSM cutoff values were 12.3 kPa (Se = 87.5%, Sp = 88%) for TE and 1.65 m/s (Se = 87.5%, Sp = 76%) for ARFI. The tests were unable to differentiate patients with histological activity from those in histological remission (P 
ISSN:2397-9070
2397-9070
DOI:10.1002/jgh3.12865