Preventing disease progression and viral suppression are the main goals of antiviral therapy in chronic hepatitis B (CHB). Liver stiffness measurement (LSM) by transient elastography is a reliable non-invasive method to assess liver fibrosis in patients with CHB. Our aim was to explore factors that may affect changes in LSMs during long term tenofovir (TDF) monotherapy in a well characterized cohort of patients with compensated CHB. We analyzed serial LSMs in 103 adult patients with CHB who were on TDF monotherapy and had at least three LSMs over a period of 90 months. Twenty-five (24%) patients had advanced fibrosis at baseline. A significant decline in mean LSM between baseline and last visit (8.7 ± 6.2 kPa vs. 6.7 ± 3.3, p = 10− 3) was observed. Twenty-four (23%) patients had progression of liver fibrosis with mean increase in liver stiffness of 2.8 kPa (range: 0.2–10.2 kPa). Multivariate analysis showed that BMI ≥ 25 (OR, 0.014; 95% CI, 0.001–0.157; p = 0.001) and advanced fibrosis (OR, 5.169; 95% CI, 1.240–21.540; p = 0.024) were independently associated with a fibrosis regression of > 30% of liver stiffness compared to baseline value. In CHB patients TDF monotherapy resulted in liver fibrosis regression, especially in patients with advanced fibrosis. Despite the successful antiviral effect of TDF, 1 out of 4 patients had liver fibrosis progression. Obesity and advanced fibrosis at baseline were independently associated with significant liver fibrosis regression.

中文翻译：

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富马酸替诺福韦二吡呋酯 (TDF) 对慢性乙型肝炎 (CHB) 患者的成功治疗并不能保证通过瞬时弹性成像评估的肝损伤得到改善。回顾性-前瞻性多中心研究

预防疾病进展和病毒抑制是慢性乙型肝炎 (CHB) 抗病毒治疗的主要目标。通过瞬时弹性成像进行肝硬度测量 (LSM) 是评估慢性乙型肝炎患者肝纤维化的可靠非侵入性方法。我们的目的是在一组特征明确的代偿性慢性乙型肝炎患者中，探讨长期替诺福韦 (TDF) 单药治疗期间可能影响 LSM 变化的因素。我们分析了 103 名接受 TDF 单药治疗且在 90 个月内至少接受过 3 次 LSM 的成年 CHB 患者的连续 LSM。二十五名 (24%) 患者在基线时患有晚期纤维化。观察到基线和上次访问之间平均 LSM 显着下降（8.7 ± 6.2 kPa 与 6.7 ± 3.3，p = 10− 3）。 24 名 (23%) 患者出现肝纤维化进展，肝脏硬度平均增加 2.8 kPa（范围：0.2-10.2 kPa）。多变量分析显示，BMI ≥ 25（OR，0.014；95% CI，0.001–0.157；p = 0.001）和晚期纤维化（OR，5.169；95% CI，1.240–21.540；p = 0.024）与纤维化独立相关与基线值相比，肝脏硬度消退 > 30%。在 CHB 患者中，TDF 单一疗法导致肝纤维化消退，特别是对于晚期纤维化患者。尽管 TDF 具有成功的抗病毒作用，但四分之一的患者出现肝纤维化进展。基线时的肥胖和晚期纤维化与显着的肝纤维化消退独立相关。