DIFFERENCE OF LIVER STIFFNESS AFTER ACUTE OR CHRONIC LIVER INJURY DUE TO VIRAL HEPATITIS

Abstract

Background/Aims: Liver stiffness (LS) measurement by transient elastography is a noninvasive method that can estimate degrees of liver fibrosis in patients with chronic liver disease. Recently, there have been several reports that LS is increased in acute viral hepatitis patients. However, long term data of LS after recovery of acute viral hepatitis are still lacking. This needs to be assessed to know if there is any sequel in terms of fibrosis in these patients. In the present study, we evaluated difference of LS between patients who recovered from acute viral hepatitis more than 1 year ago and healthy control group, acute viral hepatitis patients, chronic hepatitis patients.

Patients/Method: Among patients who had admitted at Korea University Ansan Hospital between January 2006 and January 2007 due to acute viral hepatitis (A, B or C) and recovered were enrolled (Group A, n=22). We measured the LS and compared with those of healthy control group (Group B, n=17), current acute viral hepatitis group (Group C, n=31) and chronic hepatitis group - the patients who have viral replication over 1 year but show normal sonographic finding - (Group D, n=31). The statistical methods used were Mann-Whitney U-test in continuous variables and Chi-square test or Fisher’s exact test in categorial variables. P values less than 0.05 were considered statistically significant.

Result: In Group A, mean ALT level was 24.4 (8-51) IU/L and there was no statistic difference from ALT level of Group B, 20.5 (8-50) IU/L (p=0.318). LS was also not significantly different (Group A, 5.02 (3.3-7.2) kPa vs. Group B, 4.37 (1.8-6.3) kPa, p=0.154). But when compared with Group C (ALT 1649.9 (15-5514), p<0.001) and LSM (12.9(6.3-44.3), p<0.001) and with Group D (ALT 101.9 (12-476)IU/L, p=0.047 and LSM 10.7 (3.2-48.8) kPa, p<0.001),Group A had lower ALT and LSM values.

Conclusion: LS of patients who recovered from acute viral hepatitis more than 1 year ago was shown to be similar to healthy control group but significant difference was observed in comparison with current acute viral hepatitis patients or chronic hepatitis patients. It is considered that chronic liver fibrosis is not developed in patients who recovered from acute viral hepatitis.