Utility of real-time tissue elastography in the sequential evaluation of liver fibrosis in patients with chronic hepatitis C

Liver fibrosis is related to hepatocarcinogenesis in patients with chronic hepatitis C. Real-time tissue elastography (RTE) is a useful tool for evaluating liver fibrosis. In this study, we investigated the clinical utility of RTE to sequentially evaluate liver fibrosis in 30 patients with chronic hepatitis C undergoing interferon-based therapy. We compared the change in liver fibrosis index measured by RTE before and after treatment with the change in aminotransferase-to-platelet ratio index. In addition, we compared them across patients who were divided into two groups based on pretreatment alanine transaminase (ALT) level. Liver fibrosis index at pretreatment and at achievement of sustained virological response were 2.27 and 1.94 (p=0.0003), respectively. The aminotransferase-to-platelet ratio index also decreased significantly from 0.78 to 0.40 (p<0.0001). The liver fibrosis index showed significant improvement in both the ALT elevated group (ALT≥31 IU/L) (p=0.0265) and the persistently normal ALT group (ALT<30 IU/L) (p=0.0234). By contrast, the aminotransferase-toplatelet ratio index did not show significant improvement in the persistently normal ALT group (p=0.2813). We consider RTE as one of the non-invasive modalities, which can replace liver biopsy for sequential evaluation of liver fibrosis in patients with chronic hepatitis C.

real-time tissue elastography

liver fibrosis

HCV

interferon