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Enhanced liver fibrosis test predicted liver-related events in patients with chronic HBV

Enhanced liver fibrosis testing was accurate in predicting the development of liver-related events in patients with chronic hepatitis B virus infection, according to a study published in Hepatology.

“To our knowledge, this is the first study conducted in a longitudinal setting in Asia to reveal the clinical usefulness of the [enhanced liver fibrosis] test with reference to histological fibrosis stage in Asian patients with [chronic HBV] of a homogenous etiology,” the researchers wrote.

Researchers analyzed data from the database of Severance Hospital at Yonsei University College of Medicine in Seoul, Korea, of 170 treatment-naive Korean patients with chronic HBV infection. All patients (mean age, 45.3 years; 103 men) had undergone an enhanced liver fibrosis (ELF) test and liver biopsy on the same day between 2008 and 2010. All patients were followed for a median of 41 months and regulated for any development of liver-related events (LRE), such as hepatocellular carcinoma, hepatic decompensation or mortality.

Overall, 22.9% of patients (n = 39) experienced an LRE; 23 patients experienced hepatic decompensation, 31 developed HCC and 15 died of liver-related causes. The median time to the first LRE was 7 months, and the incidence rate for an LRE increased from 1 year (14.3%) to 5 years (27.7%).

The patients who experienced LREs were older, more likely to be male and all had higher ELF test results, age-spleen-platelet ratio, liver stiffness value and proportion of histological cirrhosis, compared with patients who did not experience an LRE (P < .05), according to the research. Multivariate analysis showed age and ELF test to be independent predictors for developing a LRE (P < .001).

For better risk stratification of the patient population, researchers divided the patients into three tiers and used cutoff ELF values of 8.1 and 10.4. In doing so, they found that patients with low (P = .002) or intermediate (P < .001) ELF range were less likely to develop an LRE compared with patients in the high ELF range.  

“We showed a significant association between ELF test and the risk of LRE development in Asian patients with [chronic HCV],” the researchers concluded. “Thus, although the ELF test cannot replace [liver biopsy] completely, it may at least supplement [liver biopsy], especially in predicting long-term clinical outcomes in patients with [chronic HBV].” 

Disclosure: The researchers report no relevant financial disclosures.