Impact of Fibroscan on management of chronic viral hepatitis in clinical practice.

BACKGROUND Liver stiffness measurement (LSM) using Fibroscan is an increasingly popular non-invasive method for quantifying liver fibrosis in patients with chronic viral hepatitis. We aimed to explore potential impact of Fibroscan on clinical management. MATERIAL AND METHODS 133 patients with chronic hepatitis B (HBV, n = 75) or C (HCV, n = 58) underwent Fibroscan measurement. LSM results were compared with liver biopsy results, ultrasound, and APRI-scores, and the impact of LSM on clinical management was evaluated. RESULTS LSM results indicated fibrosis stage F0-F1 in 84 patients (63%), F2 in 28 (21%), F3 in 8 (6%), and F4 in 13 patients (10%). Nineteen patients had liver biopsies within one year of LSM. In ten patients, LSM and biopsy showed the same fibrosis stage, in 8 there was one stage difference, and in 1 three stages difference. Ultrasound only showed cirrhosis in three patients, who all exhibited advanced cirrhosis at LSM. There was a statistically significant, but weak correlation between LSM results and APRI scores (r = 0.31, pvalue < 0.001). LSM results changed clinical management in 39% of patients (55 cases): in 15 patients antiviral treatment was indicated, in 21 patients surveillance for hepatocellular carcinoma was indicated, and 19 successfully treated hepatitis C patients could be discharged from clinical follow-up in absence of severe fibrosis or cirrhosis. CONCLUSION LSM appears to be a valuable non-invasive tool to manage patients with chronic viral hepatitis in clinical practice.