Abstract
Background
Time-varying impact of anti-viral therapy on liver stiffness in patients with hepatitis
B is unclear.
Aims
To estimate the magnitude and kinetics of change in liver stiffness in hepatitis B
patients treated with nucleot(s)ide analogs.
Methods
Through a systematic review of multiple databases, we identified 24 studies in adults
with hepatitis B who underwent transient elastography before and at least 6 months
after starting nucleot(s)ide analogs therapy. We estimated change in liver stiffness
6 m, 12 m, 24 m, 36 m and 60 m after starting therapy, as weighted mean difference
and 95% confidence intervals, using random-effects meta-analysis.
Results
Liver stiffness significantly declined by 2.21 kPa (95% CI, −1.36 to −3.05), 2.56 kPa
(−2.23 to −2.89), 3.73 kPa (−2.98 to −4.49), 4.15 kPa (−2.75 to −5.54), and 5.19 kPa
(−3.34 to −7.03) at 6 months, 1 year, 2 years, 3 years, and 5 years from the start
of therapy, respectively (p < 0.001). High baseline alanine aminotransferase level,
viral load and liver stiffness were associated with greater magnitude of decline in
liver stiffness.
Conclusions
Antiviral therapy is associated with progressive decline in liver stiffness in patients
with hepatitis B, particularly in patients with high baseline alanine aminotransferase
and viral load.
Keywords
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Article info
Publication history
Published online: May 15, 2018
Accepted:
May 5,
2018
Received in revised form:
April 27,
2018
Received:
February 12,
2018
Identification
Copyright
© 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
