Prognostic Effects of Liver Fibrosis and Steatosis Determined Using Transient Elastography in Patients with Chronic Hepatitis B or C

BackgroundThe prognostic effects of liver fibrosis and steatosis in patients with chronic hepatitis B or C are unclear. We investigated the prognostic effects of liver fibrosis and steatosis determined through transient elastography (TE) in patients with chronic hepatitis B or C.MethodsThis retrospective cohort study enrolled 5528 patients with chronic hepatitis B or C who received TE. Multivariate Cox regression was used to evaluate the associations between fibrosis and steatosis grades and the occurrence of hepatic-related events, cardiovascular events, and mortality. Liver stiffness measurements of >= 7.1, >= 9.5, and >= 12.5 kPa were considered to indicate significant fibrosis (>= F2), advanced fibrosis (>= F3), and cirrhosis (>= F4), and controlled attenuation parameters of >= 230 and >= 264 dB/m were considered to indicate mild (S1) and moderate-to-severe (S2-S3) steatosis, respectively.ResultsDuring a median follow-up of 3.1 years, 489 patients died, 814 had hepatic-related events, and 209 had cardiovascular events. The incidences of these outcomes were lowest among individuals with no- or mild-fibrosis (F0-F1), and increased with fibrosis severity. The incidence of adverse outcomes was highest among patients without steatosis (S0) and lowest among those with moderate-to-severe steatosis. Adjusted models indicated that F2, F3, and F4 were independent risk factors and that moderate-to-severe steatosis was a favorable marker for hepatic-related events. Cirrhosis was an independent factor for mortality.ConclusionsAccording to TE, increasing fibrosis grades and absence of steatosis were associated with higher risks of hepatic-related events, whereas cirrhosis was a risk factor for mortality in patients with chronic hepatitis B or C.

Automated summary

This study investigated the prognostic effects of liver fibrosis and steatosis in patients with chronic hepatitis B or C. The results showed that increasing fibrosis severity was associated with higher risks of hepatic-related events, whereas the presence of steatosis had a protective effect. Cirrhosis was found to be an independent risk factor for mortality.