Articles

Liver Stiffness Measurement by Fibroscan in Patients With Hepatitis B

Abstract

About 6 percent (2%-7%) of the world’s population is chronically infected by the hepatitis B virus (HBV). The role of fibroscan for fibrosis assessment in HBV patients has not been widely studied. The present study was designed for the assessment of hepatic fibrosis by fibroscan in HBV positive patients. This is a cross-sectional study with two groups of case and control. According to the physical examination, lab data, abdominal ultrasound, and hepatitis viral load, the case group was categorized into three subgroups: inactive carrier, chronic hepatitis, and cirrhosis. The Control group was selected from a healthy population of 145 HBV patients, and 370 healthy persons entered the study. The case group included 35 inactive carriers, 63 chronic hepatitis B, and 47 cirrhotic patients, and their mean amount of fibrosis (measured by fibroscan) was 6.169 kpa, 7.758 kpa, and 24.0255 kpa, respectively. Also, the mean amount of fibrosis was 5.5510 (SD=2.43) in the control group. There was a statistically significant difference between cirrhotic patients and other groups (P<0.001). Also, a strong association between viral load and fibrosis degree was observed in chronic hepatitis B patients (P<0.001, R2=0.7811). Fibroscan is a novel instrument for the estimation of the liver fibrotic stage in HBV cirrhotic patients.

1. Gall SA. Immunology update: hepatitis B virus immunization today. Infectious diseases in obstetrics and gynecology 2001;9:63-4.
2. Nabulsi MM, Araj GF, Nuwayhid I, Ramadan M, Ariss M. Prevalence of hepatitis B infection markers in Lebanese children: the need for an expanded programme on immunization. Epidemiology and infection 2001;126:285-9.
3. Mast EE, Margolis HS, Fiore AE, et al. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) part 1: immunization of infants, children, and adolescents. MMWR Recommendations and reports : Morbidity and mortality weekly report Recommendations and reports 2005;54:1-31.
4. Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: Globocan 2000. International journal of cancer 2001;94:153-6.
5. Merat S, Malekzadeh R, Rezvan H, Khatibian M. Hepatitis B in Iran. Archives of Iranian medicine 2000;3:192-201.
6. Vergniol J, Foucher J, Terrebonne E, et al. Noninvasive tests for fibrosis and liver stiffness predict 5-year outcomes of patients with chronic hepatitis C. Gastroenterology 2011;140:1970-9, 9 e1-3.
7. Ratziu V, Charlotte F, Heurtier A, et al. Sampling variability of liver biopsy in nonalcoholic fatty liver disease. Gastroenterology 2005;128:1898-906.
8. Sharma P, Dhawan S, Bansal R, et al. Usefulness of transient elastography by FibroScan for the evaluation of liver fibrosis. Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology 2014;33:445-51.
9. Castera L, Forns X, Alberti A. Non-invasive evaluation of liver fibrosis using transient elastography. Journal of hepatology 2008;48:835-47.
10. Bota S, Sporea I, Peck-Radosavljevic M, et al. The influence of aminotransferase levels on liver stiffness assessed by Acoustic Radiation Force Impulse Elastography: a retrospective multicentre study. Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver 2013;45:762-8.
11. Pavlov CS, Casazza G, Nikolova D, Tsochatzis E, Gluud C. Systematic review with meta-analysis: diagnostic accuracy of transient elastography for staging of fibrosis in people with alcoholic liver disease. Alimentary pharmacology & therapeutics 2016;43:575-85.
12. Sandrin L, Fourquet B, Hasquenoph JM, et al. Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. Ultrasound in medicine & biology 2003;29:1705-13.
13. Yoneda M, Mawatari H, Fujita K, et al. Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with nonalcoholic fatty liver disease (NAFLD). Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver 2008;40:371-8.
14. Myers RP, Pomier-Layrargues G, Kirsch R, et al. Feasibility and diagnostic performance of the FibroScan XL probe for liver stiffness measurement in overweight and obese patients. Hepatology 2012;55:199-208.
15. Kim SU, Lee JH, Kim DY, et al. Prediction of liver-related events using fibroscan in chronic hepatitis B patients showing advanced liver fibrosis. PloS one 2012;7:e36676.
16. Maimone S, Calvaruso V, Pleguezuelo M, et al. An evaluation of transient elastography in the discrimination of HBeAg-negative disease from inactive hepatitis B carriers. Journal of viral hepatitis 2009;16:769-74.
17. Huang R, Jiang N, Yang R, et al. Fibroscan improves the diagnosis sensitivity of liver fibrosis in patients with chronic hepatitis B. Experimental and therapeutic medicine 2016;11:1673-7.
18. EASL-ALEH Clinical Practice Guidelines: Non-invasive tests for evaluation of liver disease severity and prognosis. Journal of hepatology 2015;63:237-64.
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IssueVol 58, No 11 (2020) QRcode
SectionArticles
DOI https://doi.org/10.18502/acta.v58i11.5145
Keywords
Fibroscan chronic hepatitis B cirrhosis inactive carrier

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How to Cite
1.
Bahari A, Hoseinian SM, Esmaeelzadeh A, Ganji A, Bari Z. Liver Stiffness Measurement by Fibroscan in Patients With Hepatitis B. Acta Med Iran. 2021;58(11):577-581.