Clinical application of transient elastography in patients with chronic viral hepatitis receiving antiviral treatment

Liver Int. 2015 Apr;35(4):1103-15. doi: 10.1111/liv.12628. Epub 2014 Jul 19.

Abstract

Accurate evaluation of the degree of liver fibrosis in patients with chronic liver diseases (CLD) is crucial, as liver fibrosis is important in determining the prognosis of liver diseases. Currently, liver biopsy (LB) is considered the gold standard for staging liver fibrosis or cirrhosis. However, utilization of LB in clinical practice is often limited because of its invasive nature, sampling error and interobserver variability. Recently, transient elastography (TE) was introduced as a noninvasive, highly reproducible technique for assessing the degree of liver fibrosis. After extensive studies, TE is now regarded as a reliable surrogate marker for grading the severity of liver fibrosis in patients with CLD. In the past few years, the role of TE in monitoring liver stiffness and determining prognosis in patients with chronic hepatitis B (CHB) or chronic hepatitis C (CHC) who are undergoing antiviral treatment has been investigated. In patients with CHB, liver stiffness values decrease with antiviral treatment. TE can also be used to predict the incidence of liver-related events during antiviral treatment. In patients with CHC, TE can be used to monitor potential regression of liver fibrosis after antiviral treatment and may predict the treatment outcome of CHC. In addition, TE is an adjunct tool for distinguishing inactive hepatitis B virus carriers from patients with chronic active hepatitis. This review article discusses the important findings from recent studies focusing on the clinical application of TE in patients with chronic viral hepatitis who are undergoing antiviral treatments.

Keywords: antiviral treatment; chronic hepatitis B; chronic hepatitis C; fibroscan; hepatitis B virus; hepatitis C virus; liver stiffness; transient elastography.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Biopsy
  • Elasticity
  • Elasticity Imaging Techniques / methods*
  • Hepatitis B, Chronic / complications
  • Hepatitis B, Chronic / diagnosis*
  • Hepatitis B, Chronic / drug therapy
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / diagnosis*
  • Hepatitis C, Chronic / drug therapy
  • Humans
  • Liver / drug effects
  • Liver / pathology*
  • Liver Cirrhosis / diagnosis*
  • Liver Cirrhosis / drug therapy
  • Liver Cirrhosis / virology
  • Predictive Value of Tests
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Antiviral Agents