Interpretation of liver stiffness measurement‐based approach for the monitoring of hepatitis B patients with antiviral therapy: A 2‐year prospective study

Summary Liver biopsy is not routinely performed in treated chronic hepatitis B. Liver stiffness measurement has been validated for noninvasive liver fibrosis assessment in pretreatment chronic hepatitis B but has not been assessed for fibrosis monitoring during antiviral therapy. Liver stiffness was systemically monitored by Fibroscan® every 6 months in a cohort of patients with hepatitis B receiving antiviral therapy and compared with liver biopsies at baseline and week 104. A total of 534 hepatitis B e antigen‐positive treatment‐naive patients receiving telbivudine‐based therapy with qualified liver stiffness measurement at baseline and week 104 were analyzed, 164 of which had adequate paired liver biopsies. Liver stiffness decreased rapidly (−2.2 kPa/24 weeks) in parallel with alanine aminotransferase (ALT) from 8.6 (2.6‐49.5) kPa at baseline to 6.1 (2.2‐37.4) kPa at week 24. Interestingly, liver stiffness decreased slowly (−0.3 kPa/24 weeks) but continually from week 24 to week 104 (6.1 vs 5.3 kPa, P