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News

Non-invasive tests for fibrosis and liver stiffness predicts survival with Hep B virus

A study in this month's Alimentary Pharmacology & Therapeutics investigates non-invasive tests for fibrosis and liver stiffness predict 5-year survival of patients chronically infected with hepatitis B virus.

News image

Liver stiffness and non-invasive tests predict overall survival in chronic hepatitis C.

However, in patients chronically infected with hepatitis B virus (HBV), only the association between liver stiffness and the risk of hepatocellular carcinoma has been published.

Dr de Lédinghen and colleagues from Bordeaux, France evaluate the 5-year prognostic value of liver stiffness, non-invasive tests of liver fibrosis, and liver biopsy, to predict overall survival in chronic hepatitis B.

The team prospectively assessed fibrosis, with liver stiffness, FibroTest, APRI, FIB-4 and liver biopsy.

The research team examined death and liver transplantation during a 5-year follow-up, and factors associated with overall survival.

The doctors assessed that a total of 600 patients with chronic hepatitis B were included.

Overall survival was 94%
Alimentary Pharmacology & Therapeutics

At 5 years, 25 patients were dead, and 4 patients had liver transplantation.

The research team noted that overall survival was 94%, and survival without liver-related death 96%.

No liver-related death was observed in inactive carriers.

Survival was significantly decreased in patients diagnosed with severe fibrosis, whatever the non-invasive method used, or liver biopsy.

The team of doctors examined that patients' prognosis decreased as liver stiffness and FibroTest increased.

In multivariate analysis, FibroTest and liver stiffness had the highest hazard ratio with survival.

The association persisted after adjustment on age, necro-inflammatory histological activity presumed by ActiTest and treatment.

Dr Lédinghen's team concluded, "Liver stiffness measurement or FibroTest can predict survival in chronic hepatitis B virus infection."

"Thus, these tools may help physicians to early assess prognosis and discuss specific treatments, such as liver transplantation."

Aliment Pharmacol Ther 2013: 37(10): 979-988
20 May 2013

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