Impact of Fibroscan on management of chronic viral hepatitis in clinical practice

Ann Hepatol. Oct-Dec 2011;10(4):469-76.

Abstract

Background: Liver stiffness measurement (LSM) using Fibroscan is an increasingly popular non-invasive method for quantifying liver fibrosis in patients with chronic viral hepatitis. We aimed to explore potential impact of Fibroscan on clinical management.

Material and methods: 133 patients with chronic hepatitis B (HBV, n = 75) or C (HCV, n = 58) underwent Fibroscan measurement. LSM results were compared with liver biopsy results, ultrasound, and APRI-scores, and the impact of LSM on clinical management was evaluated.

Results: LSM results indicated fibrosis stage F0-F1 in 84 patients (63%), F2 in 28 (21%), F3 in 8 (6%), and F4 in 13 patients (10%). Nineteen patients had liver biopsies within one year of LSM. In ten patients, LSM and biopsy showed the same fibrosis stage, in 8 there was one stage difference, and in 1 three stages difference. Ultrasound only showed cirrhosis in three patients, who all exhibited advanced cirrhosis at LSM. There was a statistically significant, but weak correlation between LSM results and APRI scores (r = 0.31, pvalue < 0.001). LSM results changed clinical management in 39% of patients (55 cases): in 15 patients antiviral treatment was indicated, in 21 patients surveillance for hepatocellular carcinoma was indicated, and 19 successfully treated hepatitis C patients could be discharged from clinical follow-up in absence of severe fibrosis or cirrhosis.

Conclusion: LSM appears to be a valuable non-invasive tool to manage patients with chronic viral hepatitis in clinical practice.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antiviral Agents / therapeutic use
  • Biopsy
  • Elasticity Imaging Techniques*
  • Female
  • Hepatitis B, Chronic / complications
  • Hepatitis B, Chronic / diagnosis*
  • Hepatitis B, Chronic / therapy
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / diagnosis*
  • Hepatitis C, Chronic / therapy
  • Humans
  • Liver Cirrhosis / diagnosis*
  • Liver Cirrhosis / therapy
  • Liver Cirrhosis / virology
  • Male
  • Middle Aged
  • Netherlands
  • Predictive Value of Tests
  • Prognosis
  • Severity of Illness Index
  • Time Factors
  • Young Adult

Substances

  • Antiviral Agents