CHRONIC hepatitis B virus infection (HBV) is a serious global health problem .About 257 million people are HBsAg +ve worldwide. Liver biopsy (LB) is considered as the gold standard for assessing liver fibrosis. Due to invasiveness and high–cost, the application of liver biopsy in the evaluation of liver fibrosis is limited. Liver stiffness measurement (LSM) using transient elastography (FibroScan) has been introduced for assessing liver fibrosis with accurate, reproducible, and reliable results. The study aimed to compare and validate the results of fibroscan versus liver biopsy among chronic HBV patients. Methods: Fifty four  chronic HBV patients who are having a standard indication for liver biopsy(EASL) were included  . Inclusion criteria were males and females above 18 years, HBeAg positive or negative cases with normal or fluctuating liver enzymes. Exclusion criteria included concomitant HCV infection, evidence of liver disease induced by other causes ex:Alcohol were excluded, and age less than 18 years. Patients were subjected to liver biopsy and fibroscan study.  Liver biopsy  were performed and interpreted in the same laboratory for all the patients. Fibroscan was performed by the same operator for all the patients.

Results: The mean age of our patients was 36. Study population showed male predominance. The mean AST was 28.01U/L and the mean ALT level was 30.2U/L.HBV DNA levels were quite variable with a minimum of <1000IU/ML and a maximum of 1,10,056 IU/ML with a mean of 6135.2. Liver biopsy results showed that 36 cases had a fibrosis score of (F0)/F1 18 cases (F 2/F3). Fibroscan showed 42 patients in F0/F1 and 12 patients in F2/F3. Of total 54 patients fibroscan is able to accurately predict the degree of fibrosis in 46 patients (85%) .Of the remaining 8 patients in whom the fibroscan is not correlating with liver biopsy fibroscan values are in the range of 6–9 kpa. This study shows that fibroscan <6 KPa would exclude significant fibrosis and those with  LSM >9 KPa would predict significant fibrosis in which liver biopsies can be avoided. The liver biopsy is required in patients with LSM between 6 – 9 KPa.

Conclusion:

Liver stiffness measurement could be used as a predictor for liver fibrosis in chronic HBV patients  but still liver biopsy may be required to confirm  treatment decisions.