FibroScan Detection of Fatty Liver/Liver Fibrosis in 2266 Cases of Chronic Hepatitis B

Abstract

Background and Aims: FibroScan is used to determine liver stiffness and controlled attenuation parameter (referred to as CAP) scores in patients, including those with chronic hepatitis B (CHB). We used FibroScan to detect the incidence of fatty liver and fibrosis in CHB patients, and to assess the correlation of FibroScan measurements with blood chemistry tests. Methods: CHB patients enrolled in this study were divided independently for three separate analyses (of fibrosis, cirrhosis, and fatty liver) based on FibroScan results. Basic information, blood chemistry test results, liver fibrosis parameters, and FibroScan results were collected. T-tests and Pearson's analyses were used to analyze the correlations between FibroScan liver stiffness measurement/CAP values and liver function, blood fat, uric acid metabolite, fibrosis, and hepatitis B virus load. Results: A total of 2266 CHB patients were enrolled in the study and divided into three groups: non-significant and significant fibrosis; non-cirrhosis and early cirrhosis; and non-fatty and fatty liver. Spearman's statistical analyses showed that liver stiffness measurement or CAP values correlated with sex (r=0.137), age (r=0.119), glutamic-pyruvic transaminase (r=0.082), glutamic-oxaloacetic transaminase (r=-0.172), gamma-glutamyltransferase (r=0.225), albumin (r=0.150), globulin (r=-0.107), total bilirubin (r=-0.132), direct bilirubin (r=-0.145), white blood cell count (r=0.254), hemoglobin (r=0.205), platelets (r=0.206), total cholesterol (r=0.214), high density lipoprotein (r=-0.243), low density lipoprotein (r=0.255), apolipoprotein B (r=0.217), hyaluronic acid (r=-0.069), laminin (r=-0.188), procollagen type IV (r=-0.067)and hepatitis B viral DNA load (r=-0.216). Conclusions: FibroScan is a non-invasive device that can detect the occurrence of fatty liver or liver fibrosis in CHB patients.

Definition and classification of acute-on-chronic liver diseases

“…In contrast, ACLF should be diagnosed once liver failure occurs in CHB patients with active intrahepatic inflammation and/or fibrosis. However, since most patients with chronic HBV infection lack liver histological evidence, the status of liver inflammatory activity and fibrosis can be judged only indirectly by referring to the levels of serum ALT/AST and liver stiffness (detected by transient elastography)[ 41 , 42 ]. Thus, for patients with chronic HBV infection who do not show obvious signs and symptoms of active hepatitis but may have different degrees of inflammatory activity and fibrosis histologically, the dynamic monitoring of the ALT/AST levels and liver stiffness could facilitate the assessment of liver inflammatory activity and fibrosis, respectively, which is helpful for distinguishing ALF/SALF from ACLF[ 41 , 43 ].…”

Rate of liver fibrosis and some related factors in senior military officers examined at Military Hospital 121 in 2021-2022

“…Theo nhiều công bố, nguyên nhân chủ yếu dẫn đến xơ hóa gan là do viêm gan B và uống rượu [12], trong nghiên cứu của chúng tôi tỷ lệ đối tượng nghiên cứu xử dụng nhiều rượu bia (≥3 đơn vị rượu/ngày) và tỷ lệ viêm gan B khá cao với 53,9% và 6,9%, đây là các yếu tố nguy cơ thúc đẩy xơ hóa gan gia tăng. Nghiên cứu của Lư Quốc Hùng (2018) trên đối tượng có viêm gan vi rút ghi nhận kết quả F0=13,04%, F1=21,74%, F2=21,74%, F3=18,48%, F4=25% [5], nghiên cứu của Tingshan He (2020) ghi nhận 34,42% người viêm gan B có xơ gan [10]. Nghiên cứu của Nguyễn Khắc (2008) ghi nhận tỷ lệ các giai đoạn xơ hóa gan ở bệnh nhân nghiên rượu là 23,3% F2, 19,4% F3 và 32% F4 [11], tương tự Nguyễn Khắc, tác giả Đinh Tiến Đồng (2017) cũng ghi nhận tỷ lệ giai đoạn xơ hóa gan ở bệnh nhân uống nhiều rượu là 18,9% F2, 5,4% F3 và 24,3% F4 [3].…”