Frequency of significant fibrosis in various chronic liver diseases: an evaluation with Transient Elastography (TE)

• Main Authors: shahrani, shahreedhan, balakrishnan, preetica mayuri, ravi, koshni, singh, sandeep, chee, sher wye, zulkeflie, saiful hasyim, zhuang, ng ying, lee, wai kin, amin, Mohamed, sooi, choong yeong, CK, vikneshwaran, Nik Muhamad Affendi, Nik Arsyad, skantha, ruben, Limun, Mohd Fairul, mohamed talha, abdul malik, Chuah, Kee Huat, stanley, khoo, Rajaram, Ruveena Bhavani, chan, wah keong, Mahadeva, Sanjiv,
• Format: Conference or Workshop Item
• Language: English
• Published: 2022
• Subjects: R Medicine (General)
• Online Access: http://irep.iium.edu.my/99669/2/99669_FREQUENCY%20OF%20SIGNIFICANT%20FIBROSIS.pdf; http://irep.iium.edu.my/99669/
• Institution: Universiti Islam Antarabangsa Malaysia

INTRODUCTION: Liver biopsy has long been the gold standard to evaluate liver fibrosis. TE was developed as a non- invasive method to assess liver fibrosis by measuring liver stiffness using shear wave velocity. Many studies have proven its’ effectiveness as a method for evaluating liver fibrosis.1-2 The use of TE in UMMC began in 2013. OBJECTIVE: To determine the frequency and aetiology of liver fibrosis and cirrhosis in our local population METHOD: This was a retrospective study conducted at UMMC. Inclusion criteria was all patients who had TE performed from 1 January 2013 to 31 December 2021. Their demographics, clinical characteristics and TE findings were charted. RESULTS: A total of 3066 patients were included, in which 51.7% were males and 48.3% were females. The median CAP value was 271 dB/m. The median E value was 6.5kPa. 11.2% and 11.3% of patients had significant fibrosis (10.1-14.9kPa) and cirrhosis(≥15kPa) respectively. Non-alcoholic fatty liver disease (NAFLD) was noted to be the most common aetiology for fibrosis (32.8%), followed by chronic hepatitis B (CHB) at 25.2%, chronic hepatitis C (CHC) at 6.7% and alcoholic liver disease (ALD) with 1.3%. This finding was also found to be similar in the cirrhosis group (NAFLD 32.5%, CHB 17.2%, CHC 11.9% and ALD 1.4%). 219 DISCUSSION: Our study shows that the most common cause for significant fibrosis and cirrhosis is NAFLD. This is in contrast with previous studies, that reported the most common aetiology being CHB.3-4 This is likely due to the availability of effective treatment for hepatitis B and C. This may also be attributed to the initiation of the national Hepatitis B vaccination program for newborns and the improvement in blood transfusion safety. CONCLUSION: NAFLD has the greatest frequency of fibrosis compared with other aetiologies of liver disease - mainly as there is no effective treatment, unlike viral hepatitis.