APASL 2021
Acute Liver Failure and Artificial Liver Support
1
Regression of liver fibrosis after HBsAg loss: a prospective matched case-control evaluation using transient elastography and serum Enhanced Liver Fibrosis (ELF) test
Dr. Lung-Yi Mak1,2, Dr. Danny Ka-Ho Wong1,2, Dr. Rex Wan-Hin Hui1, Dr. Ka-Shing Cheung1,4, Dr. Fen Liu, Dr. James Fung3, Prof. Wai-Kay Seto1,2,4, Prof. Man-Fung Yuen1,2
1The University Of Hong Kong,
2State Key Lab of Liver Research, The University of Hong Kong,
3Department of Gastroenterology and Hepatology, The First Affiliated Hospital, Sun Yat-Sen University,
4Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China,
Background:
We assessed the effect of hepatitis B surface antigen (HBsAg) seroclearance on liver fibrosis regression in patients with
chronic hepatitis B (CHB).
Methods:
CHB patients with recent spontaneous HBsAg seroclearance (cases) were age- and gender- matched with treatmentnaïve HBeAg-negative CHB infection (controls). Paired transient elastography (TE) and Enhanced Liver Fibrosis (ELF) measurements were performed at baseline and 3-year. Fibrosis progression and regression were defined as increase and decrease in ≥1 fibrosis stage, respectively.
Results:
In this interim analysis, 40 cases and 142 controls were recruited [median age 55.6 (interquartile range, IQR 49.8-60.9), 53.8% male]. The median liver stiffness (LS) values were similar between the two groups at baseline (5.4 vs. 5.2 kPa, P=0.765) and at 3-years (5.9 vs. 5.5 kPa, P=0.455) respectively. The baseline controlled attenuation parameter values were significantly higher in cases vs controls (288 vs 251 dB/m, respectively, P=0.001). The median ELF at 3-year was significantly higher than baseline in the controls (8.6 vs. 8.4, P=0.033). All patients with severe steatosis had significantly higher baseline LS (5.9 vs. 4.8 kPa; P<0.001), 3-year LS (6.4 vs 5.2 kPa; P<0.001), and baseline ELF (8.8 vs. 8.3, P=0.028).
The proportion of patients with fibrosis progression (25.6% vs. 15.5%, respectively, P=0.111) and regression (10.3% vs. 14.8%, P=0.604) was similar in cases vs controls.
Conclusions:
Over a period of 3 years, fibrosis regression and progression were observed at a similar rate in patients with HBsAg seroclearance compared to patients with inactive CHB. Severe hepatic steatosis was associated with higher LS and ELF.
