Dynamic Changes of the Aspartate Aminotransferase‐to‐Platelet Ratio and Transient Elastography in Predicting a Histologic Response in Patients With Chronic Hepatitis B After Entecavir Treatment. (23rd September 2018)

• Record Type: Journal Article
• Authors: Sun, Jing; Li, Yanfang; Sun, Xuying; Yu, Hong; Liu, Youde
• Is Part Of: Journal of ultrasound in medicine. Volume 38:Number 6(2019)
• Page Start: 1441
• Page End: 1448
• Publication Date: 2018-09-23
• Subjects: aspartate aminotransferase -- chronic hepatitis B -- hepatic fibrosis -- platelets -- transient elastography; Ultrasonics in medicine -- Periodicals; Ultrasonics; Ultrasonography; Ultrasonics in medicine; Electronic journals; Periodicals; Periodicals; 616.07543
• DOI: 10.1002/jum.14822
• Languages: English
• ISSNs: 0278-4297

Abstract

Abstract : Objectives: To evaluate the dynamic changes of the aspartate aminotransferase (AST)‐to‐platelet ratio and transient elastography (FibroScan; Echosens, Paris, France) in predicting a histologic response in patients with chronic hepatitis B (CHB) after entecavir treatment. Methods: A total of 148 patients with CHB were enrolled. Patient information was collected. All patients received liver biopsy and FibroScan before and after 96 weeks of entecavir treatment. Results: Baseline liver biopsy results showed that there were 7 patients without liver fibrosis (fibrosis stage F0; 4.7%), 51 patients with mild liver fibrosis (F1; 34.5%), and 90 patients with advanced liver fibrosis (>F1; 60.9%). The liver stiffness value and AST‐to‐platelet ratio increased significantly as the METAVIR score of the patients increased from F0 to F4 ( P < .001). After antiviral therapy for 96 weeks, the average liver stiffness value measured by FibroScan and the AST‐to‐platelet ratio showed a significant decrease. When we use a decreased liver stiffness value to predict a histologic response, the area under the receiver operating characteristic curve was 0.70 (95% confidence interval, 0.61–0.79; P < .001), and the sensitivity and specificity were 74.3% and 68.8%, respectively. The decrease of the AST‐to‐platelet ratio also could predict the histologic response of patients with CHB; the area under the receiver operating characteristic curve was 0.77 (95% confidence interval, 0.69–0.86; P < .001) with sensitivity of 76.2% and specificity of 70.2%. A multivariate analysis indicated that a high hepatitis B virus DNA viral load (odds ratio, 1.44; P = .04) and high METAVIR score (odds ratio, 1.38; P = .02) were independent risk factors for the histologic response. Conclusions: Both the AST‐to‐platelet ratio and FibroScan value can effectively predict a histologic response in patients with CHB during entecavir treatment. Therefore, they can be used to monitor these patients during antiviral treatment to avoid multiple liver biopsies.