1. Impact of Fibroscan® on management of chronic viral hepatitis in clinical practice
- Author
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Renske E. Blom, Karel J. van Erpecum, Claudia Verveer, Hanneke van Soest, Robert E. de Knegt, Joop E. Arends, Dietje E. Fransen van de Putte, Eveline P. Mauser-Bunschoten, and Marco W. Mundt
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Cirrhosis ,Adolescent ,Biopsy ,Specialties of internal medicine ,Antiviral Agents ,Severity of Illness Index ,Gastroenterology ,Young Adult ,Hepatitis B, Chronic ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,Aged ,Netherlands ,Ultrasonography ,Hepatology ,medicine.diagnostic_test ,business.industry ,General Medicine ,Hepatitis C ,Hepatitis C, Chronic ,Middle Aged ,Hepatitis B ,Prognosis ,medicine.disease ,Fibrosis ,RC581-951 ,Liver biopsy ,Hepatocellular carcinoma ,Predictive value of tests ,Liver cirrhosis ,Elasticity Imaging Techniques ,Female ,business ,Viral hepatitis - Abstract
Background. Liver stiffness measurement (LSM) using Fibroscan® is an increasingly popular non-invasive me¬thod for quantifying liver fibrosis in patients with chronic viral hepatitis. We aimed to explore potential im¬pact of Fibroscan® on clinical management.Material and methods. 133 patients with chronic hepatitis B (HBV, n = 75) or C (HCV, n = 58) underwent Fibroscan® measurement. LSM results were compared with li-ver biopsy results, ultrasound, and APRI-scores, and the impact of LSM on clinical management was evalua¬ted.Results. LSM results indicated fibrosis stage F0-F1 in 84 patients (63%), F2 in 28 (21%), F3 in 8 (6%), and F4 in 13 patients (10%). Nineteen patients had liver biopsies within one year of LSM. In ten patients, LSM and biopsy showed the same fibrosis stage, in 8 there was one stage difference, and in 1 three stages di¬fference. Ultrasound only showed cirrhosis in three patients, who all exhibited advanced cirrhosis at LSM. There was a statistically significant, but weak correlation between LSM results and APRI scores (r = 0.31, p-value < 0.001). LSM results changed clinical management in 39% of patients (55 cases): in 15 patients antivi¬ral treatment was indicated, in 21 patients surveillance for hepatocellular carcinoma was indicated, and 19 successfully treated hepatitis C patients could be discharged from clinical follow-up in absence of severe fibrosis or cirrhosis.Conclusion. LSM appears to be a valuable non-invasive tool to manage patients with chronic viral hepatitis in clinical practice.
- Published
- 2011
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