TRANSIENT ELASTOGRAPHY AND BIOMARKERS FOR LIVER FIBROSIS ASSESSMENT AND FOLLOW-UP OF INACTIVE HEPATITIS B CARRIERS

Laurent Castera (1) , Pierre-Henri Bernard (1) , Brigitte Lebail (2) , Juliette Foucher (3) , Pascale Trimoulet (4) , Wassil Merrouche (5) , Patrice Couzigou (5) , Victor de Ledinghen (1)

1 Service d'Hépato-Gastro-Entérologie
2 Service de pathologie [Bordeaux]
3 Service de Biochimie [Mondor]
4 Service de virologie et d'immunologie biologique
5 Département d'hépatologie et de gastroentérologie

ABSTRACT Aim To evaluate longitudinally transient elastography (TE) and biomarkers for liver fibrosis assessment and follow-up of hepatitis B virus (HBV) inactive carriers. Methods Three hundred and twenty-nine consecutive HBeAg-negative HBV patients (201 inactive carriers) who underwent TE, Fibrotest® and APRI the same day were studied. Results TE (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 between 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. Conclusions Non invasive tools, particularly transient elastography, 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.

Mots clés: Medicine

Laurent Castera, Pierre-Henri Bernard, Brigitte Lebail, Juliette Foucher, Pascale Trimoulet, et al.. TRANSIENT ELASTOGRAPHY AND BIOMARKERS FOR LIVER FIBROSIS ASSESSMENT AND FOLLOW-UP OF INACTIVE HEPATITIS B CARRIERS. Alimentary Pharmacology and Therapeutics, 2010, 33 (4), pp.455. ⟨10.1111/j.1365-2036.2010.04547.x⟩. ⟨hal-00602613⟩