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Acute viral hepatitis increases liver stiffness values measured by transient elastography
Author(s) -
Arena Umberto,
Vizzutti Francesco,
Corti Giampaolo,
Ambu Silvia,
Stasi Cristina,
Bresci Silvia,
Moscarella Stefania,
Boddi Vieri,
Petrarca Antonio,
Laffi Giacomo,
Marra Fabio,
Pinzani Massimo
Publication year - 2008
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.22007
Subject(s) - transient elastography , cirrhosis , medicine , gastroenterology , viral hepatitis , alanine aminotransferase , liver disease , fibrosis , hepatitis c , stage (stratigraphy) , hepatitis , liver fibrosis , pathology , biology , paleontology
Liver tissue alterations other than fibrosis may have an impact on liver stiffness measurement. In this study we evaluated 18 patients without a previous clinical history of liver disease, consecutively admitted for acute viral hepatitis. In each patient, aminotransferase determination and liver stiffness measurement were performed on the same study day, at 3 different points: (1) peak increase in aminotransferase; (2) aminotransferase 50% or less of the peak; (3) aminotransferase levels ≤2× the upper limit of normal. In all patients, the degree of liver stiffness at the time of the peak increase in aminotransferases exceeded the cutoff values proposed for the prediction of significant fibrosis or cirrhosis. A progressive significant reduction in liver stiffness values was observed ( P < 0.0001) in the follow‐up period in parallel with the reduction of aminotransferase levels ( P < 0.0001). Moreover, a statistically significant, positive correlation between aminotransferases and liver stiffness measurement (LSM) at the onset of acute viral hepatitis was found ( r = 0.53, P = 0.02 and r = 0.51, P = 0.03 for alanine aminotransferase and aspartate aminotransferase, respectively). In conclusion, the extent of necroinflammatory activity needs to be carefully considered in future studies aimed at further validating transient elastography, particularly in patients with absent or low‐stage liver fibrosis (in other words, F0‐F2 METAVIR). LSM does not represent a reliable instrument to detect the presence of advanced fibrosis and cirrhosis in patients presenting with a clinical picture of acute hepatitis. (H EPATOLOGY 2007.)