Hepatology

Biography

Biography: M Abdel Samie

Abstract

Background: Transient Elastography (TE) is a non-invasive and reproducible tool to assess liver fibrosis/cirrhosis. However, it remains to be determined if ALT flare interferes with fibrosis assessment. Aim: To determine the effect of increased serum ALT on liver stiffness measurement in patients with acute viral hepatitis. Methods: Thirty consecutive patients with acute hepatitis of virus etiology with elevation of liver enzymes (>10 folds of ULN) were prospectively included. Blood samples were collected and TE was done initially and after resolution of hepatitis and after normalization of liver enzymes. Patients with high BMI which could affect fibroscan and patients with cirrhosis were excluded. For determination of the etiology of hepatitis, a detailed physical examination, history taking and laboratory tests were performed in all patients. Results: Patients were 32.87±10.2 years old and males were 14 (46.7%). In all patients, the degree of liver stiffness at the time of the peak increase in aminotransferases exceeded the cutoff values proposed for the prediction of significant fibrosis or cirrhosis. The mean value of LSM at the time of inclusion in the study was 13.91±6.7 kPa and the mean value of LSM after resolution of hepatitis was 7.7±3.08 kPa. A progressive significant reduction in liver stiffness values was observed (P<0.01) in the follow-up period in parallel with the reduction of ALT levels (P<0.01). Moreover, a statistically significant, positive correlation between ALT and LSM at the onset of acute viral hepatitis was found (r=0.38, P<0.05). No significant correlation was found between increased total bilirubin level and LSM (r=0.3 and P>0.05). Reduction of mean value to 6.21±1.14 kPa was observed in 10 patients after 1 year of ALT normalization. Conclusion: TE has not demonstrated reliable diagnostic accuracy in patients with acute viral hepatitis.