Studying the Effect of Hepatic Steatosis on Liver Stiffness Measurement (LSM) in HBV Patients With and Without Therapy

TL;DR

This study examines how liver stiffness measurements relate to fatty liver in hepatitis B patients, finding limited diagnostic value in treated individuals.

Contribution

The study evaluates the diagnostic value of liver stiffness measurement in HBV patients with and without treatment for fatty liver.

Findings

LSM showed limited diagnostic value for hepatic steatosis in the treatment group.

LSM had satisfactory diagnostic value in the untreated group.

LSM did not significantly correlate with age, gender, BMI, or steatosis degree in HBV patients.

Abstract

The issue of fatty liver disease is becoming more widely acknowledged as a global health concern. This disorder manifests as inflammation brought on by varied degrees of fat buildup in the liver tissue. Since studies have shown that fatty liver is a major factor affecting the prognosis of patients with chronic hepatitis, the coexistence of viral hepatitis and fatty liver is noteworthy. Transient elastography is a useful technique for identifying and measuring the degree of steatosis. The liver stiffness measurement (LSM) index might be a good substitute for these patients if it shows a high diagnostic value in identifying hepatic steatosis.

This pilot study presents an analytical cross-sectional analysis of 53 hepatitis B patients (26 men and 27 women) who sought care at Aria Hospital in Ahvaz, Iran, between April 2023 and November 2024. Participants were divided into two groups: 34 patients in the treatment group and 19 patients in the nontreatment group. The subjects' prevalence of hepatic fibrosis was evaluated using transient elastography and the LSM index. Further comparisons between treatment-receiving and nonreceiving patients were conducted using LSM.

The prevalence of steatosis was found to be 25% in the untreated group and 26.7% in the treatment group. In the treatment group, the incidence of fibrosis was 58.8%, while in the untreated group, it was 57.9%. In both the treatment-treated and nontreated groups of hepatitis B patients, the associations between the study variables and the LSM index were evaluated. Every correlation that was found was not statistically significant. Additionally, the LSM's diagnostic value for hepatic steatosis was evaluated. In the treatment group, the test showed limited diagnostic value, while in the untreated group, it showed satisfactory diagnostic value.

In patients with hepatitis B, the LSM derived from transient elastography does not show a statistically significant correlation with factors such as age, gender, body mass index (BMI), or degree of hepatic steatosis. According to this study, the LSM number is not a reliable indicator for identifying hepatic steatosis in patients with hepatitis B when compared to the CAP score (AUC = 0.69 and 0.74).