ACCURACY OF TRANSIENT ELASTOGRAPHY IN IDENTIFYING FIBROSIS AMONG PATIENTS WITH CHRONIC HEPATITIS B: A CROSS-SECTIONAL OBSERVATIONAL STUDY

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ACCURACY OF TRANSIENT ELASTOGRAPHY IN IDENTIFYING FIBROSIS AMONG PATIENTS WITH CHRONIC HEPATITIS B: A CROSS-SECTIONAL OBSERVATIONAL STUDY

Abstract:
Background: Hepatitis B virus (HBV) infection is a significant global public health problem, affecting millions of people worldwide. Liver biopsy is the gold standard for assessing fibrosis but is invasive
and carries post-procedural risks. Noninvasive tests to evaluate liver fibrosis are needed, and
transient elastography is one such method. This cross-sectional observational study aimed to
assess the accuracy of transient elastography in identifying fibrosis among patients with chronic
hepatitis B.

Methods: The study was conducted at the Department of Medicine and Hepatology,
Sir Salimullah Medical College Mitford Hospital, Dhaka. The study subjects were patients diagnosed
with chronic hepatitis B infection, both outpatient and inpatient cases. Data were collected from 25
patients using convenient and purposive sampling techniques. Demographic data, clinical
examination, and relevant investigations were recorded in a structured case report form. Data were
processed, registered, edited, computerized, and analyzed.

Results: The study included 25 patients with a mean age of 26.8±6.5 years, predominantly male (80%). All patients were HBsAg positive, 12.0% were HBeAg positive, and 56.0% were antiHBe positive. The mean HBV DNA PCR was 1516293.4±7475976.3 IU/ml. The mean ALT level was 45.4±13.8 U/L. The mean liver stiffness measurement (LSM) was 7.5±2.3 kPa, with 64.0% of patients showing fibrosis stage F0-F1. The
mean periportal +/- bridging necrosis was 2.92±1.58, intralobular degeneration and focal were
1.16±0.55, portal inflammation was 2.52±0.87, histological activity index was 6.6±2.2, and fibrosis
score was 1.44±1.04. Positive correlations were observed between LSM and histological activity
index (r=0.239; p=0.251) and between LSM and fibrosis score (r=0.107; p=0.612).Conclusion: Our
study demonstrates that transient elastography provides a non-invasive, easy, and cost-effective
method for identifying fibrosis in chronic hepatitis B patients, serving as a potential alternative to
liver biopsy.