Changes in Liver Stiffness after Acute or Chronic Liver Injury due to Viral Hepatitis - Does Fibrosis Exist after Recovery from Acute Viral Hepatitis?

Jeong Han Kim; Hyung Joon Yim; Seung Young Kim; Jae Hong Ahn; Young Kul Jung; Moon Kyung Joo; Su Hyun Kim; Ji Hoon Kim; Yeon Seok Seo; Jong Eun Yeon; Hong Sik Lee; Soon Ho Um; Sang Woo Lee; Kwan Soo Byun; Jae Hyun Choi; Ho Sang Ryu

doi:10.4166/kjg.2009.54.3.155

Journal List > Korean J Gastroenterol > v.54(3) > 1006576

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Kim, Yim, Kim, Ahn, Jung, Joo, Kim, Kim, Seo, Yeon, Lee, Um, Lee, Byun, Choi, and Ryu: Changes in Liver Stiffness after Acute or Chronic Liver Injury due to Viral Hepatitis - Does Fibrosis Exist after Recovery from Acute Viral Hepatitis?

Original Article

Korean J Gastroenterol 2009;54(3):155-161.

Published online: 21 February 2009

DOI: https://doi.org/10.4166/kjg.2009.54.3.155

Changes in Liver Stiffness after Acute or Chronic Liver Injury due to Viral Hepatitis - Does Fibrosis Exist after Recovery from Acute Viral Hepatitis?

Jeong Han Kim, M.D., Hyung Joon Yim, M.D., Seung Young Kim, M.D., Jae Hong Ahn, M.D., Young Kul Jung, M.D., Moon Kyung Joo, M.D., Su Hyun Kim, M.D.^∗, Ji Hoon Kim, M.D., Yeon Seok Seo, M.D., Jong Eun Yeon, M.D., Hong Sik Lee, M.D., Soon Ho Um, M.D., Sang Woo Lee, M.D., Kwan Soo Byun, M.D., Jae Hyun Choi, M.D., Ho Sang Ryu, M.D.

Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea

^†Department of Family Medicine, Korea University College of Medicine, Seoul, Korea

Correspondence to: Hyung Joon Yim, M.D. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, 516, Gojan 1-dong, Danwon-gu, Ansan 425-707, Korea Tel: +82-31-412-6565, Fax: +82-31-412-5582 E-mail: gudwns21@medimail.co.kr

Received 17 February 2009 Accepted 8 April 2019

Abstract

Background/Aims

Liver stiffness (LS) measurement by transient elastography can estimate the degrees of liver fibrosis in patients with chronic liver disease. However, longitudinal data of LS after recovery of acute viral hepatitis are still lacking. In the present study, we aimed to evaluate among LS of patients at various stages of viral hepatitis and normal control.

Methods

Patients who had admitted at Korea University Ansan Hospital between January 2006 and January 2007 due to acute viral hepatitis and recovered were recruited (group A, n=22). We compared the liver biochmistry and LS of group A with those of healthy control group (group B, n=23), current acute viral hepatitis group (group C, n=49), and chronic viral hepatitis group (group D, n=66).

Results

Mean ALT, total bilirubin, and LS level of group A were not different from group B (p=0.318, p=0.116, p=0.125, respectively). However, group A had lower ALT, total bilirubin, and LS values compared to group C (all p ＜0.001), and lower ALT and LS values compared to group D (p=0.007, p＜0.001). The mean total bilirubin was not significantly different from group D (p=0.117).

Conclusions

Our data suggest that liver fibrosis is a longterm sequela of chronic hepatitis, and not developed in patients who recovered from acute viral hepatitis.

Keywords: Transient elastography, Liver stiffness, Acute viral hepatitis, Fibrosis

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Fig. 1.

Comparison of biochemistry and liver stiffness among recovered group (group A) and other groups (group B, C, or D). (A) ALT: Group A showed significant difference compared with group C and group D, but not with group B. (B) Total bilirubin: Group A showed significant difference compared with group C, but not with group B and group D. (C) Liver stiffness: Group A showed significant difference compared with group C and group D, but not with group B. Group A, recovered group; Group B, healthy control group; Group C, current acute hepatitis group; Group D, chronic hepatitis group.

Table 1.

Baseline Characteristics

Variables	Group A (n=22)	Group B (n=23)	Group C (n=49)	Group D (n=66)
Male^∗	12 (54.5%)	8 (34.8%)	30 (61.2%)	50 (75.8%)
Age (years)	34±8.0 (19-59)	48.7±16.4 (20-77)	33.0±7.9 (16-60)	40.2±9.9 (17-68)
AST (IU/L)	37.5±30.1 (11-127)	22.4±6.6 (12-40)	1016.9±1008.8 (30-4,802)	77.9±76.4 (17-706)
ALT (IU/L)	24.4±12.9 (8-51)	19.3±10.6 (8-50)	1914.8±1784.7 (16-5,586)	117.7±116.2 (7-928)
Total bilirubin (mg/dL)	1.0±0.7 (0.6-1.7)	0.7±0.3 (0.3-1.3)	6.1±3.4 (0.9-15.6)	1.0±0.4 (0.3-2.4)
Albumin (g/dL)	4.4±0.3 (3.7-4.8)	4.3±0.3 (3.8-4.9)	3.7±0.3 (3.0-4.4)	4.3±0.4 (2.8-4.9)
Stiffness (kPa)	5.02±1.2 (3.3-7.2)	4.4±1.1 (1.8-6.3)	13.3±7.4 (6.3-44.3)	8.8±7.0 (3.2-48.8)

Group A, recovered group; Group B, healthy control group; Group C, current acute hepatitis group; Group D, chronic hepatitis group. All data are expressed as mean±standard deviation (range) except.

^∗ Expressed in number (percentile).

Table 2.

Factors Correlated with Liver Stiffness Adjusted by Gender

Variables	Correlation coefficient	p-value
Age	−0.002	0.985
AST	0.179	0.049
ALT	0.211	0.02
Total bilirubin	0.452	＜0.001
ALP^∗	0.224	0.014
γ-GT	0.287	0.001
Albumin	−0.415	＜0.001
Platelet	−0.087	0.341

^∗ ALP, alkaline phosphatase.

Table 3.

Linear Regression Analysis of Continuous Variables with Liver Stiffness

Variables	Univariate analysis		Multivariate analysis
Variables	p-value	Adjusted R²	p-value	Adjusted R²
Age	0.409	−0.002
AST	0.019	0.028	0.316
ALT	0.005	0.044	0.393
Total bilirubin	＜0.001	0.224	0.001	0.222
ALP	＜0.001	0.093	0.228
γ-GT	0.001	0.078	0.294
Albumin ＜	＜0.001	0.166	0.024
Platelet	0.585	−0.004

ALP, alkaline phosphatase.

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