Low liver stiffness among cirrhotic patients with hepatitis B after prolonged treatment with nucleoside analogs

• Published in: Scandinavian journal of gastroenterology 2011-06, Vol.46 (6), p.760-766
• Main Authors: Andersen, Ellen Sloth, Weiland, Ola, Leutscher, Peter, Krarup, Henrik, Westin, Johan, Moessner, Belinda, Konopski, Zbigniew, Frigstad, Svein-Oskar, Kjær, Mette, Christensen, Peer Brehm, Weis, Nina
• Format: Article
• Language: English
• Subjects: Adenine - analogs & derivatives; Adenine - therapeutic use; Adult; Biological and medical sciences; Cirrhosis; Elasticity Imaging Techniques; Female; Gastroenterology. Liver. Pancreas. Abdomen; hepatitis B; Hepatitis B - complications; Hepatitis B - drug therapy; Human viral diseases; Humans; Infectious diseases; Lamivudine - therapeutic use; Liver - pathology; Liver Cirrhosis - complications; Liver Cirrhosis - drug therapy; Liver Cirrhosis - pathology; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; nucleoside analogs; Organophosphonates - therapeutic use; Other diseases. Semiology; Reverse Transcriptase Inhibitors - therapeutic use; Tenofovir; Time Factors; transient elastography; Viral diseases; Viral hepatitis
• ISSN: 0036-5521; 1502-7708
• DOI: 10.3109/00365521.2011.565068

Abstract Objective. Case reports and short-term clinical trials have suggested that treatment for chronic hepatitis B (CHB) may lead to improvement of cirrhosis. The aim of the present study was to measure liver stiffness in patients diagnosed with advanced fibrosis or cirrhosis prior to prolonged treatment with nucleoside or nucleotide analogs (NUCs) for CHB. Materials and methods. Patients with CHB and advanced fibrosis or cirrhosis prior to treatment with NUCs for at least 1 year were offered inclusion in the study. We measured liver stiffness using transient elastography (TE) at follow-up. TE cut-off levels to Metavir classification for fibrosis stage F2, F3 and F4 were ≥7.2 kPa, ≥8.1, and ≥11.0 kPa, respectively. Results. Among 66 patients with a successful TE examination at follow-up, 53 patients (80%) had cirrhosis and 13 had (20%) advanced fibrosis (F3) prior to treatment. Median treatment duration was 50.5 months. Among patients with cirrhosis prior to treatment, 26 (49%) had liver stiffness below 11.0 kPa at follow-up, suggesting regression of cirrhosis. Among patients with advanced fibrosis (F3) prior to treatment, 10 (77%) had liver stiffness below 8.1 kPa after treatment, suggesting improvement of fibrosis. Conclusion. Transient elastography examinations demonstrate that prolonged treatment with NUCs in patients with CHB results in low liver stiffness, suggesting regression of fibrosis in a majority of patients with advanced fibrosis or cirrhosis.