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Early steep decline of liver stiffness predicts histological reversal of fibrosis in chronic hepatitis B patients treated with entecavir 期刊论文

编号：

abcd72a9-77da-4f0a-bf20-f0994b4af977
作者：

Kong, Yuanyuan^[1,2,3];Sun, Yameng^[1,2,3];Zhou, Dialing^[1,2,3];Wu, Xiaoning^[1,2,3];Chen, Yongpeng^[4];Piao, Hongxin^[5];Lu, Lungen^[6];Ding, Huiguo^[7];Nan, Yuemin^[8];Jiang, Wei(蒋炜)^[9]Xu, Youqing^[10];Xie, Wen^[11];Li, Hanwei^[12];Feng, Bo^[13];Shi, Guangfeng(施光峰)^[14]Chen, Guofeng^[15];Li, Hai^[16];Zheng, Huanwei^[17];Cheng, Jilin(程计林)^[18]Wang, Tailing^[19];Liu, Hui^[20];Lv, Fudong^[20];Shao, Chen^[19];Mao, Yimin^[21];Sun, Jihong^[22];Chen, Tao^[23];Han, Tao^[24];Han, Ying^[25];Wan, Lin^[1,2,3];Ou, Xiaojuan^[1,2,3];Zhang, Hui^[26];Jia, Jidong^[1,2,3];You, Hong^[1,2,3];
语种：

英文
期刊：

JOURNAL OF VIRAL HEPATITIS ISSN：1352-0504 2019 年 26 卷 5 期 (576 - 585) ; MAY
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关键词：

antiviral therapy chronic hepatitis B liver fibrosis liver stiffness measurement reversibility
摘要：

It is unknown whether dynamic changes of liver stiffness measurement (LSM) can predict the reversibility of fibrosis. Therefore, we evaluated the utility of LSM changes in predicting histological changes of fibrosis in patients with chronic hepatitis B (CHB) on antiviral therapy. In a prospective cohort of CHB patients treated with entecavir, virological measurement and biochemical measurement along with LSM were measured at baseline and every 6 months. Liver biopsies were conducted at baseline and month 18 of treatment. Fibrosis regression was defined by the following two criteria: (a) Ishak score decrease >= 1 stage, (b) Ishak score decrease >= 1 stage or predominantly regressive by post-treatment PIR classification. The dynamic changes of LSM and its predictive value for histological reversibility were evaluated with piecewise linear mixed-effects model and ROC analysis. We found that at month 18 of antiviral therapy, liver fibrosis was reserved in 86 of 212 (40.6%) CHB patients by Ishak reversal criterion. Overall, a decline in LSM was associated with attenuation of Ishak score. The rate of LSM decline in the first 6 months was significantly faster in patients with fibrosis reversal (Delta LSM%(Ishak) = -2.19%/month, P = 0.0025; Delta LSM%(Ishak/PIR) = -2.56%/month, P = 0.0004). The predictive model based on baseline FIB-4 and Ishak score as well as baseline LSM, PLT, albumin and their changes during the first 6 months could predict histological reversal (AUROC(Ishak) = 0.74, 95% CI: 0.67-0.80; AUROC(Ishak/PIR) = 0.81, 95% CI: 0.74-0.87). We conclude that in CHB patients, changes in LSM during the first 6 months of entecavir therapy can predict histological reversibility of liver fibrosis at month 18 of antiviral therapy.
推荐引用方式
GB/T 7714：

Kong Yuanyuan,Sun Yameng,Zhou Dialing, et al. Early steep decline of liver stiffness predicts histological reversal of fibrosis in chronic hepatitis B patients treated with entecavir [J].JOURNAL OF VIRAL HEPATITIS,2019,26(5):576-585.
APA：

Kong Yuanyuan,Sun Yameng,Zhou Dialing,Wu Xiaoning,&You Hong.(2019).Early steep decline of liver stiffness predicts histological reversal of fibrosis in chronic hepatitis B patients treated with entecavir .JOURNAL OF VIRAL HEPATITIS,26(5):576-585.
MLA：

Kong Yuanyuan, et al. "Early steep decline of liver stiffness predicts histological reversal of fibrosis in chronic hepatitis B patients treated with entecavir" .JOURNAL OF VIRAL HEPATITIS 26,5(2019):576-585.
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