Association between the reduction in liver stiffness measurement and the histological outcome of liver fibrosis regression in patients with chronic hepatitis B

Objective To investigate the association between the change in liver stiffness measurement( LSM) and the histological outcome of liver fibrosis in patients with chronic hepatitis B( CHB) during antiviral therapy. Methods In a prospective cohort of CHB patients receiving entecavir-based therapy( from July 2013 to September 2015),HBV DNA,liver function,and LSM were measured at baseline and every 6 months during treatment. According to a more stringent criteria for the change in Ishak score after treatment,the patients were divided into definite regression group( a reduction of ≥2 in Ishak score),indeterminate group( a reduction of 0-1 in Ishak score),and progression group( an increase of > 1 in Ishak score). A one-way analysis of variance was used for comparison between multiple groups. The piecewise linear mixed-effects model was used to evaluate the dynamic changes of LSM and its association with the histological outcome of liver fibrosis. The t-test was used for comparison of slope between groups. Results A total of 239 CHB patients were enrolled,and after1. 5 years of entecavir treatment,18 patients( 7. 5%) achieved the histological outcome of definite regression of liver fibrosis,196( 82. 0%)achieved indeterminate regression,and 25( 10. 5%) experienced progression. The rate of reduction in LSM within the first half year of antiviral therapy was-36. 3% in the definite regression group( 95% confidence interval [CI]:-52. 8% to-19. 7%),-23. 7% in the indeterminate group( 95% CI:-29. 7% to-17. 8%),and-12. 6%( 95% CI:-31. 0% to 5. 9%) in the progression group. In the definite regression group and the indeterminate group,the rate of reduction in LSM in the first 6 months of treatment was significantly higher than that thereafter( both P < 0. 05). Conclusion The rate of reduction in LSM is associated with the histological outcome of liver fibrosis within the first 6 months of antiviral therapy. The patients with > 30% reduction in LSM after the first 6 months of antiviral therapy tend to have a higher probability of definite regression of liver fibrosis.