Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Tropical Medicine

Background: Long-term antiviral therapy in chronic hepatitis B (CHB), will lead to suppression of viral replication, inflammatory response and eventually decrease in liver stiffness and liver fibrosis regression. Monitoring of liver stiffness measurement(LSM) and hepatic fibrosis can be done using transient elastography(TE) and serum markers. Aimis to evaluate changes in LSM during at least 2 years of oral anti-viral therapy in chronic CHB using TE and indirect serum indices for assessment of hepatic fibrosis. Methods: This study was conducted on 61 CHB patients who had received oral anti-viral treatment for at least 2 years referred to Cairo Fatemic Hospital, MOHP, and Cairo University Center for hepatic fibrosis(CUC-HF)Cairo University, Egypt. Initial and follow up assessment included LSM by TE in addition to APRI, FIB-4, AST/ALT Ratio and AST-Platelet Index. Changes of LSM, indirect markers of hepatic fibrosis were evaluated in patients with nonsignificant fibrosis ({u2264}F1) group and patients with significant fibrosis ({u2265}F2) after at least 2 years of therapy. Results: Out of 61 patients who were enrolled, 75.4% were male, mean age was 36±9 years. All patients achieved virological response. There was a significant decline in median LSM in all CHB patients (6.4-5.7 kPa, p 0.001), in patients with {u2264}F1 (5-4.8 kPa, p 0.015) and in patients with {u2265}F2 (9.5-7.8 kPa, p 0.045). Older age, higher initial liver stiffness, ALT, AST, AFP levels and lower albumin were associated with significant improvement in LS in univariate analysis

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