Treatment Response Monitoring of Chronic Hepatitis B Patients using Transient Elastography and Aspartate Aminotransferase-to-Platelet Ratio Index (APRI)
Abstract: Hepatitis B is
endemic in Indonesia and treatment response need to be monitored during and
after antiviral therapy. Liver stiffness measurement and alanine
aminotransferase-to-platelet ratio index (APRI) are noninvasive method to
detect liver fibrosis available in Indonesia. However, little is known about
their ability to evaluate treatment response in chronic hepatitis B (CHB)
patients in Indonesia. This study aimed to investigate liver stiffness changes
by transient elastography (TE) and APRI before and after one-year oral
antiviral treatment in CHB patients and the correlation between TE and APRI.
Methods: this study was retrospective cohort on CHB patients in
CiptoMangunkusumo Hospital, Jakarta who uderwent treatment between January 2012
and December 2014. Patients received oral antiviral treatment with newer
nucleoside analogues (entecavir or telbivudine) for at least one year. TE and
APRI were obtained before and after treatment. TE and APRI reductions were
analyzed statistically with Spearman’s test. Results: a total of 41 patients
were enrolled in this study. Median liver stiffness value was significantly
reduced from 10.8 to 5.9 kPa after oral antiviral treatment (p<0.001,
Wilcoxon’s test). Median APRI was also significantly reduced from 1.13 to 0.43
after treatment (p<0.001, Wilcoxon’s test). The correlation between liver
stiffness and APRI before treatment was weak (r=0.40), but it was strong after
treatment (r=0.73). Conclusion: the liver stiffness measured with transient
elastography and APRI significantly decreased after one year of antiviral
treatment in chronic HBV patients. There was a significant correlation between
TE and APRI after one year of treatment.
Keywords: antiviral therapy;
aspartate aminotransferase-to-platelet ratio index (APRI); chronic hepatitis B;
liver stiffness measurement; transient elastography
Author: Ignatius R Tenggara, C
Rinaldi Lesmana, Rino A Gani
Journal Code: jpkedokterangg170326
