Etiology-related determinants of liver stiffness values in chronic viral hepatitis B or C

Mirella Fraquelli, Cristina Rigamonti, Giovanni Casazza, Maria Francesca Donato, Guido Ronchi, Dario Conte, Mariagrazia Rumi, Pietro Lampertico, Massimo Colombo

Research output: Contribution to journalArticlepeer-review


Background & Aims: Transient elastography (TE) has gained popularity for the non-invasive assessment of severity of chronic viral hepatitis, but a comprehensive evaluation of the factors that might account for discrepancy in diagnostic accuracy between TE and the standard of care liver biopsy (LB) is still needed. Methods: Patients with chronic hepatitis-B (HBV, n = 104) or -C (HCV, n = 453) underwent percutaneous LB concomitantly with TE (FibroScan®; Echosens, Paris, France). Liver cell necroinflammatory activity (A) and fibrosis (F) were assessed by METAVIR. Perisinusoidal fibrosis was rated with a 0-3 score. Determinants of TE results were investigated by a linear regression model whereas discordance between TE and LB results was assessed by logistic regression. Results: Fibrosis (p 60 years vs. 2 UNL AST and >2 UNL GGT, as well as severe/moderate necroinflammatory activity and severe/moderate steatosis in HCV. In the latter patients, however, moderate/severe necroinflammatory activity and steatosis were the only independent predictors of fibrosis overestimation. Conclusions: Fibrosis and necroinflammatory activity are the main determinants of TE in chronic viral hepatitis. Since TE staging of fibrosis is influenced by necroinflammatory activity and steatosis, a diagnostic LB is deemed necessary for a reliable intra-patient TE monitoring of the course of viral hepatitis.

Original languageEnglish
Pages (from-to)621-628
Number of pages8
JournalJournal of Hepatology
Issue number4
Publication statusPublished - Apr 2011


  • Hepatitis B
  • Hepatitis C
  • Liver biopsy
  • Liver fibrosis
  • Transient elastography

ASJC Scopus subject areas

  • Hepatology


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