机构：[1]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China[2]Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, Beijing, China[3]National Clinical Research Center for Digestive Diseases, Beijing, China[4]Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China[5]Development of Infectious Diseases, Affiliated Hospital of Yanbian University, Yanji, China[6]Department of Gastroenterology and Hepatology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China[7]Department of Gastroenterology and Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China[8]Department of Traditional and Western Medical Hepatology, Third Hospital of Hebei Medical University, Shijiazhuang, China[9]Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, China[1]0Department of Digestive System, Beijing Tiantan Hospital, Capital Medical University, Beijing, China首都医科大学附属天坛医院[11]Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China[12]Liver Cirrhosis Treatment Center, 302 Military Hospital of China, Beijing, China[13]Hepatology Institution, Peking University People’s Hospital, Beijing, China[14]Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China[15]Second Liver Cirrhosis Diagnosis and Treatment Center, 302 Military Hospital of China, Beijing, China[16]Department of Hepatopancreatobiliary and Splenic Medicine, Affiliated Hospital, Logistics University of People’s Armed Police Force, Tianjin, China[17]Department of Infectious Disease, the Fifth Hospital of Shijiazhuang City, Shijiazhuang, China[18]Department of Gastroenterology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China[19]Development of Pathology, China-Japan Friendship Hospital, Beijing, China[20]Development of Pathology, Beijing Youan Hospital, Capital Medical University, Beijing, China[21]Department of Gastroenterology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China[22]Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China[23]Department of Infectious Disease, Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China华中科技大学同济医学院附属同济医院[24]Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin, China[25]Department of Gastroenterology, Xijing Hospital, Fourth Military Medical University, Xi’an, China[26]Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, Tennessee
It is unknown whether dynamic changes of liver stiffness measurement (LSM) can predict the reversibility of fibrosis. Therefore, we evaluated the utility of LSM changes in predicting histological changes of fibrosis in patients with chronic hepatitis B (CHB) on antiviral therapy. In a prospective cohort of CHB patients treated with entecavir, virological measurement and biochemical measurement along with LSM were measured at baseline and every 6 months. Liver biopsies were conducted at baseline and month 18 of treatment. Fibrosis regression was defined by the following two criteria: (a) Ishak score decrease >= 1 stage, (b) Ishak score decrease >= 1 stage or predominantly regressive by post-treatment PIR classification. The dynamic changes of LSM and its predictive value for histological reversibility were evaluated with piecewise linear mixed-effects model and ROC analysis. We found that at month 18 of antiviral therapy, liver fibrosis was reserved in 86 of 212 (40.6%) CHB patients by Ishak reversal criterion. Overall, a decline in LSM was associated with attenuation of Ishak score. The rate of LSM decline in the first 6 months was significantly faster in patients with fibrosis reversal (Delta LSM%(Ishak) = -2.19%/month, P = 0.0025; Delta LSM%(Ishak/PIR) = -2.56%/month, P = 0.0004). The predictive model based on baseline FIB-4 and Ishak score as well as baseline LSM, PLT, albumin and their changes during the first 6 months could predict histological reversal (AUROC(Ishak) = 0.74, 95% CI: 0.67-0.80; AUROC(Ishak/PIR) = 0.81, 95% CI: 0.74-0.87). We conclude that in CHB patients, changes in LSM during the first 6 months of entecavir therapy can predict histological reversibility of liver fibrosis at month 18 of antiviral therapy.
基金：
National Science and Technology Major Special Project for Infectious Diseases [2018ZX10302204]; National Science and Technology Major Special Project for New Drug Development [2018ZX09201016]; Beijing Nova ProgramBeijing Municipal Science & Technology Commission [Z161100004916105]; Digestive Medical Coordinated Development Center of Beijing Municipal Administration of Hospitals [XXX 0104]
第一作者机构：[1]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China[2]Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, Beijing, China[3]National Clinical Research Center for Digestive Diseases, Beijing, China[1]0Department of Digestive System, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
通讯作者：
通讯机构：[1]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China[2]Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, Beijing, China[3]National Clinical Research Center for Digestive Diseases, Beijing, China[1]0Department of Digestive System, Beijing Tiantan Hospital, Capital Medical University, Beijing, China[*1]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
推荐引用方式(GB/T 7714)：
Kong Yuanyuan,Sun Yameng,Zhou Dialing,et al.Early steep decline of liver stiffness predicts histological reversal of fibrosis in chronic hepatitis B patients treated with entecavir[J].JOURNAL OF VIRAL HEPATITIS.2019,26(5):576-585.doi:10.1111/jvh.13058.
APA：
Kong, Yuanyuan,Sun, Yameng,Zhou, Dialing,Wu, Xiaoning,Chen, Yongpeng...&You, Hong.(2019).Early steep decline of liver stiffness predicts histological reversal of fibrosis in chronic hepatitis B patients treated with entecavir.JOURNAL OF VIRAL HEPATITIS,26,(5)
MLA：
Kong, Yuanyuan,et al."Early steep decline of liver stiffness predicts histological reversal of fibrosis in chronic hepatitis B patients treated with entecavir".JOURNAL OF VIRAL HEPATITIS 26..5(2019):576-585
