Assessment of hepatic fibrosis regression by transient elastography in patients with chronic Hepatitis B treated with oral antiviral agents

Transient elastography (TE) has been used as a non-invasive method for liver stiffness measurement (LSM) in patients with chronic liver disease. This study was performed to assess the change of LSM by TE and to assess its clinical usefulness during long-term oral antiviral therapy in patients with chronic hepatitis B (CHB). We retrospectively reviewed 83 CHB patients. The mean interval between two LSM was 411.5±149.5 days. Initial and follow-up LSM was 16.15±12.41 kPa and 11.26±7.36 kPa, respectively (P<0.001). The degree of regression of liver stiffness was -2.03±0.36% per month. The fibrosis stage classified by LSM value improved in 37 (44.6%) patients during oral antiviral therapy. Of the 30 (36.1%) patients with LSM ≥ 14.1 kPa (cirrhosis) at 1st LSM, 12 (40%) proved to no longer have cirrhosis (≥1 decrease in fibrosis stage) at 2nd LSM. LSM significantly decreased in both baseline high (>upper limit of normal [ULN]×2) and low (≤ ULN×2) alanine aminotransferase groups during antiviral therapy (P<0.001; P=0.001, respectively). Long-term oral antiviral therapy resulted in the improvement of liver stiffness in a substantial portion of patients with CHB. TE may be used a useful clinical tool to assess disease progression in CHB patients.