Comparative Study between Fibroscan and Liver Biopsy Results in Chronic HBV Egyptian Patients: A Single Center Pilot Study

Objective: Recent reports have shown that liver stiffness measurement using Fibroscan allowed accurate prediction of hepatic fibrosis in patient with chronic hepatitis C but few reports are published for chronic hepatitis B especially in Egypt. The study aimed to compare and validate the results of fibroscan versus liver biopsy among chronic HBV patients who are not candidates for treatment according to Egyptian Guidelines. Methods: Thirty one chronic HBV patients not candidates for treatment were included in our study. Patients who were histologically confirmed with liver biopsy within recent 6 months were enrolled. Inclusion criteria were males and females above 18 years, HBeAg positive or negative cases with HBV DNA by 2000IU/ml with normal or fluctuating liver enzymes. Exclusion criteria included concomitant HCV infection, evidence of liver disease induced by other causes, and age less than 18 years. Patients were subjected to liver biopsy and fibroscan study. Both liver biopsy and fibroscan were performed and interpreted in Hepatology And Pathology Departments at National Hepatology and Tropical Medicine Research Institute, Cairo (NHTMRI). Results: The mean age of our patients was 35.4. Study population showed male predominance as the number of males was 25 cases (80.6%) while the number of females was 6 (19.4%). The mean ALT was 35.01U/L and the mean AST level was 30.89U/L.HBV DNA levels were quite variable with a minimum of 188IU/ML and a maximum of 80,162,000 IU/ML with a mean of 2,613,52 1. Liver biopsy results showed that 4 cases had a fibrosis score of (F0), 19 cases (F 1), 5 cases (F2), and only 3 cases (F3). Fibroscan results coincided with liver biopsy cases in all 4 cases with F0. Eleven cases with an F1 biopsy result had a less fibroscan result of F0, 5 cases had an increased fibroscan score of F2 and only three cases coincided with liver biopsy. Fibroscan results coincided with liver biopsy in 4 cases out of 5 in F2 liver biopsy group. The 3 cases that showed a liver biopsy result of F3 had a less fibroscan result of F2. Conclusion: Liver stiffness assessment was found to be correlated with liver fibrosis however the results of liver biopsy were not similar to fibroscan results. Most of the cases Correspondence to: Dr. Sahar Z. Maklad, E-mail: [email protected] had a fibroscan result less than liver biopsy results by Metavir score. Only cases with Metavir score of F0 and most of F2 coincided with fibroscan results.