Dynamic monitoring with shear wave elastography predicts outcomes of chronic hepatitis B patients with decompensated cirrhosis

Abstract

Background: Two-dimensional shear wave elastography (2D-SWE) can be used to accurately assess significant liver fibrosis in chronic hepatitis B (CHB). However, whether those with decompensated cirrhosis could benefit from surveillance with 2D-SWE remains unclear. We aimed to evaluate the association between dynamic changes in 2D-SWE measurements and the prognosis of CHB-related decompensated cirrhosis.Methods: We prospectively enrolled 149 consecutive treatment-naive CHB patients with decompensated cirrhosis from a clinical trial (registration number: ChiCTR-DCD-15006000) from February 2015 to December 2018. 2D-SWE was performed at 48-week intervals until December 2020. Liver-related events (LREs) were recorded through electronic medical records and telephone interviews. Results:The liver stiffness measurement (LSM) levels persistently reduced after antiviral therapy in patients who did not develop LREs, while patients with LREs showed a fluctuating trend of LSM alterations.Low pre-treatment 2D-SWE LSM, ∆% 2D-SWE LSM pre-virus control, and ∆% 2D-SWE LSM prepost treatment were characterized by similar prognostic abilities as high levels of these parameters. Posttreatment 2D-SWE LSM was independently correlated with LREs in multivariate Cox regression models after antiviral treatments [hazard ratio (HR) =1.05; 95% confidence interval (CI): 1.02-1.08, P=0.0007 and 1.11; 95% CI: 1.04-1.18, P=0.0026]. Receiver operating characteristic (ROC) curve analysis identified that post-treatment 2D-SWE LSM exhibited the best predictive power for LREs among all the other variables, including parameters of 2D-SWE and serum fibrosis markers (area under the curve =0.75, P<0.001). Conclusions:The last follow-up LSM, rather than pre-treatment or dynamic changes in 2D-SWE serves as a powerful predictor of LREs, suggesting that sequential monitoring may be beneficial to predicting prognosis.

Vitamin D Status Presents Different Relationships with Severity in Metabolic-Associated Fatty Liver Disease Patients with or without Hepatitis B Infection

“…The valid examination results were based on five eligible acquisitions with an interquartile range (IQR)-to-median ratio less than 0.3 for each participant. The cutoff value of LSM for significant liver fibrosis was set as 7.1 kpa [ 22 ].…”

Non-invasive tools for compensated advanced chronic liver disease and portal hypertension after Baveno VII – an update

“…Using a threshold of 11.6 kPa at baseline and follow-up, the lowest risk for liver-related events was found in patients with consistently low LSM or decreasing LSM during followup, whereas the highest risk category was found in serial TE ≥ 11.6 kPa and those who changed from values below to above this threshold after antiviral treatment [88] . Repeated measurements of LSM using 2D-SWE predicted liverrelated outcomes in a prospective cohort of 149 patients with decompensated HBV cirrhosis after a follow-up of 34.8 months [89] . There is very scarce data on the correlation of HVPG and LSM in the context of treated HBV, and this is a field for future research.…”