Long-term changes of liver stiffness values assessed using transient elastography in patients with chronic hepatitis B receiving entecavir

Background & Aims: Liver stiffness (LS) measurement using transient elastography allows for accurate evaluation of liver fibrosis in patients with chronic liver disease. We aimed to investigate the influence of antiviral treatment using entecavir (ETV) on LS values in patients with chronic hepatitis B (CHB). Methods: 121 patients with CHB who completed a 3-year ETV treatment were recruited. LS values were measured before starting ETV (baseline) and after the completion of the 3-year treatment. A significant decline in the LS value was defined as a ≥30% drop from the baseline. Results: The median baseline LS value of the patients was 14.3 kPa. However, it decreased significantly to 7.3 kPa after 3-year ETV treatment (P < 0.001). A higher baseline LS value was the single independent predictor of a significant decline in LS value on multivariate analysis (P<0.001; hazard ratio [HR], 1.155; 95% confidence interval [CI], 1.073-1.243). Using an optimal cutoff baseline LS value of 11.5 kPa (area under receiver operating characteristic curve, 0.781; 95% CI, 0.698-0.863, P < 0.001; sensitivity 75.6%; specificity, 62.8%), patients with baseline LS values of ≥11.5 kPa had a greater probability of experiencing a significant decline in the LS value than those with baseline LS values of <11.5 kPa (P < 0.001; HR, 5.240; 95% CI, 2.340-11.732). Conclusions: In patients with CHB, LS values were decreased significantly after a 3-year ETV treatment. A higher baseline LS value was the single independent predictor of a significant decline in the LS value.