Prediction of liver-related events using fibroscan in chronic hepatitis B patients showing advanced liver fibrosis

2012 PLoS ONE 7;5 (e36676)

BACKGROUND: Liver stiffness measurement (LSM) using transient elastography (FibroScan(R)) can assess liver fibrosis noninvasively. This study investigated whether LSM can predict the development of liver-related events (LREs) in chronic hepatitis B (CHB) patients showing histologically advanced liver fibrosis. METHODS: Between March 2006 and April 2010, 128 CHB patients with who underwent LSM and liver biopsy (LB) before starting nucleot(s)ide analogues and showed histologically advanced fibrosis (>/=F3) with a high viral loads [HBV DNA >/=2,000 IU/mL] were enrolled. All patients were followed regularly to detect LRE development, including hepatic decompensation (variceal bleeding, ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, hepatorenal syndrome) and hepatocellular carcinoma (HCC). RESULTS: The mean age of the patient (72 men, 56 women) was 52.2 years. During the median follow-up period [median 27.8 (12.6-61.6) months], LREs developed in 19 (14.8%) patients (five with hepatic decompensation, 13 with HCC, one with both). Together with age, multivariate analysis identified LSM as an independent predictor of LRE development [P19 kPa were at significantly greater risk than those with LSM=19 kPa for LRE development (HR, 7.176; 95% CI, 2.257-22.812; P = 0.001). CONCLUSION: LSM can be a useful predictor of LRE development in CHB patients showing histologically advanced liver fibrosis.