Originally, the new technique was proposed new product in clinical practice as a non-invasive, surrogate marker of fibrosis and many studies demonstrated good reproducibility and a high correlation between LS and liver fibrosis at histology. However, liver elasticity is influenced not only by fibrosis, but also by the presence and extent of liquid, lipid and inflammatory infiltrates within the liver. The evidence that Fibroscan (FS) is significantly influenced by major variations of liver inflammation (as we previously showed), in addition to variations of staging, prompted the new frontier of testing FS values in the management of patients with chronic hepatitis.
Research frontiers The course of liver disease in a significant proportion of chronic hepatitis B (CHB) patients is characterized by hepatitis exacerbations, intervened by prolonged remissions whose biochemical and virologic patterns can be mistaken with those of chronic inactive carriers. Thus, measuring LS might be useful to distinguish active from inactive HBV carriers. We addressed this question and present here the results of the cross-sectional and prospective studies of a large cohort of pedigreed hepatitis B virus (HBV) carriers (68 inactive carriers, 200 CHB and nine acute hepatitis B patients). Innovations and breakthroughs FS correlates with fibrosis in CHB patients and FS provides a reliable method to assess the overall status of liver disease in the carrier with chronic HBV infection. The mean FS values of HBV-inactive carriers were comparable to those of normal controls and significantly lower than those of CHB patients.
Interestingly, in HBV inactive carriers with metabolic liver disease FS values were significantly higher than in HBV-inactive carriers without liver AV-951 disease. All factors stemming for activity of liver disease, namely the phase of infection (active or inactive), HBV-DNA and ALT levels influenced LS at multivariate analysis. Accordingly, in untreated patients without cirrhosis, histological necrosis and inflammation and ALT were the only factors influencing FS in addition to fibrosis. Thus both necrosis and inflammation influence LS that qualifies as a very promising tool for the non-invasive diagnostic assessment of the liver in the HBV carrier. The best cut-off values for fibrosis and cirrhosis were significantly lower than in chronic hepatitis C (CHC) patients, studied in identical conditions (same center, instrument, operators and test timing), suggesting that FS is influenced also by the different histopathology features of CHB and CHC. This prospective study on patients with hepatitis B exacerbations confirmed 1.2 to 4.4-fold increases of FS values at the time of ALT flares. Similarly, LS paralleled ALT fluctuations in patients with acute hepatitis B.