Assessment of FibroScan on the therapeutic efficacy of entecavir treatment in cirrhotic patients with chronic hepatitis B

JI Dong; SHAO Qing; LI Bing; LI Fan; WANG Chun-yan; CHEN Song-hai; CHEN Guo-feng

Abstract：Objective To assess the usefulness of transient elastography (FibroScan) in dynamically monitoring the improve-ment of liver fibrosis in cirrhotic patients with chronic hepatitis B (CHB) receiving entecavir (ETV) treatment. Methods A total of 352 cirrhotic patients with CHB treated in our hospital were enrolled in the study. All the patients were administrated with ETV (0.5 mg/d for naive or adefovir dipivoxil-resistant patients, and 1.0 mg/d for lamivudine-resistant patients). A follow-up was conducted over a 3-year period. Liver stiffness was measured by using FibroScan, and biochemical and virological examinations were conducted every 3-6 months, so that the clinical efficacy was observed. Results After 3-year ETV treatment, 87.8% (309/352) of the patients achieved virological response (defined as HBV DNA<40 IU/ml). The values of liver stiffness measurement at baseline and 3-year treatment were 30.8 (17.3, 46.4) kPa and 18.6 (12.0, 27.9) kPa, respectively, and the difference was significant (P=0.000). Of 352 patients, 34 (9.7%) underwent virological breakthrough (defined as an increase of ≥1 log10 IU/ml in HBV DNA from nadir during the treatment) due to various reasons, and the values of liver stiffness measurement and the levels of ALT and TBIL were significantly higher than those at baseline (P<0.01). Conclusions FibroScan is useful for dynamically monitoring the changes in the severity of liver fibrosis in cirrhotic patients with CHB during antiviral treatment, and FibroScan examination can be considered as a credible al-ternative to liver biopsy.