Liver Stiffness Test Identifies Which Patients Develop Liver Damage After Treatment Stops

— Christine M. Kukka, Project Manager, HBV Advocate

With powerful antivirals now available, more hepatitis B patients are achieving very low viral loads and some can even stop treatment after they achieve undetectable HBV DNA. But which of these patients remain at risk of liver damage after treatment stops?

Korean researchers say that an ultrasound test that measures liver stiffness can identify which patients who stop treatment will develop liver disease (such as cirrhosis) even after they clear HBV DNA.

The researchers followed 192 patients (average age 49, 70% male) who achieved complete response (with viral loads less than 20 international units per milliliter – IU/mL) after entecavir treatment. They measured the patients’ liver stiffness using transient elastography (Fibroscan.) The average measurement was 8.8 kPa, but over time those who were older and had liver stiffness measurements of 13 kPa or higher tended to develop cirrhosis (liver scarring) and fibrosis (inflammation).

The liver stiffness measurements were more accurate in diagnosing which patients were still at risk of liver damage than relying simply on viral load, researchers noted in their study published in the June issue of the American Journal of Gastroenterology.

“Thus, in the era of potent antiviral therapy. tailored surveillance strategies might be established based upon liver stiffness values (after achieving) complete viral response,” they concluded.

Source: www.ncbi.nlm.nih.gov/pubmed/24957159

HBV Journal Review
July 1, 2014, Vol 11, no 7
by Christine M. Kukka

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