Transient elastography and biomarkers for liver fibrosis assessment and follow-up of inactive hepatitis B carriers
Transient elastography and biomarkers for liver fibrosis assessment and follow-up of inactive hepatitis B carriers
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DOI：
10.1111/j.1365-2036.2010.04547.x
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发表时间：
2011-02-15
影响因子：
7.6
通讯作者：
de Ledinghen, V.
中科院分区：
文献类型：
--
作者：
Castera, L.;Bernard, P. -H.;de Ledinghen, V.
无创性肝纤维化评估方法在B型肝炎中仍有待纵向验证。目的评估纵向瞬时弹性成像（TE）和生物标志物用于肝纤维化评估和随访B病毒（HBV）非活动性携带者。对201名非活动性携带者进行了研究，这些携带者在同一天接受了TE、Fibrotest和天冬氨酸与血小板比率指数（APRI）。（中位数4.8 vs. 6.8 kPa，P < 0.0001），Fibrotest（0.16 vs. 0.35，P < 0.0001）和APRI值（0.28对0.43，P < 0.0001），但不影响正常工作。非活动性携带者的HBV DNA水平显著低于其余患者，而非活动性携带者之间的HBV DNA水平无差异。在82例重复检查的非活动性携带者中，尽管在个体患者中观察到差异，但TE值随时间推移无显著差异（随访结束时相对于基线的患者内变化中位数：-0.2 kPa，P = 0.12）。而Fibrotest（+0.03，P = 0.012）和APRI（-0.01，P = 0.05）则有明显波动。11名非活动携带者（5.5%）有初始TE值升高（> 7.2 kPa），在随访过程中证实，在两个显着的纤维化（F2和F3）肝biopsiz.ConclusionNon-invasive工具，特别是TE，可能是有用的，除了HBV DNA和转氨酶水平，随访HBV非活动携带者以及更好地选择需要肝活检的患者。
P>BackgroundNon invasive methods for fibrosis evaluation remain to be validated longitudinally in hepatitis B.AimTo evaluate longitudinally transient elastography (TE) and biomarkers for liver fibrosis assessment and follow-up of hepatitis B virus (HBV) inactive carriers.MethodsThree hundred and twenty-nine consecutive HBeAg-negative HBV patients (201 inactive carriers) who underwent TE, Fibrotest and aspartate to platelet ratio index (APRI) the same day were studied.ResultsTE (median 4.8 vs. 6.8 kPa, P < 0.0001), Fibrotest (0.16 vs. 0.35, P < 0.0001) and APRI values (0.28 vs. 0.43, P < 0.0001) were significantly lower in inactive carriers than in the remaining patients whereas they did not differ among inactive carriers according to HBV DNA levels. In 82 inactive carriers with repeated examinations, although differences were observed among individual patients, TE values did not differ significantly over time (median intra-patient changes at end of follow-up relative to baseline: -0.2 kPa, P = 0.12). Conversely, significant fluctuations were observed for Fibrotest (+0.03, P = 0.012) and APRI (-0.01, P < 0.05). Eleven inactive carriers (5.5%) had initial elevated TE values (> 7.2 kPa) confirmed during follow-up in two with significant fibrosis (F2 and F3) on liver biopsy.ConclusionNon-invasive tools, particularly TE, could be useful, in addition to HBV DNA and transaminase levels, for follow-up of HBV inactive carriers as well as better selection of patients who require a liver biopsy.