Assessment of liver fibrosis and cirrhosis by transient elastography among patients with chronic HBV and HCV infection in Georgia.

The aim of the study was to evaluate liver fibrosis (LF) and cirrhosis using Transient elastography (TE) using Fibroscan in patients with chronic HBV and HCV infection. The device evaluates LF by measurement of liver stiffness (LS). 525 patients with chronic HCV infection and 105 patients with chronic HBV infection were included in the study. These patients were investigated at the Georgian-French joint hepatology clinic "Hepa" from November 2007, till November 2008. Among investigated HBV infected 105 patients 65 (61.9%) had no fibrosis (LS<5.5 kpa), 23 (21.9%) had mild fibrosis (LS-5.5-8.0 kpa), 9 (8.6%) had severe fibrosis (LS-8.0-14.0 kpa) and 8 (7.6%) had liver cirrhosis (LS>14.0 kpa). Among investigated HCV infected 525 patients 200 (38.1%) had no fibrosis (LS<5.5 kpa), 139 (26.5%) patients had mild fibrosis (LS-5.5-8.0 kpa), 87 (16.5%) patients had severe fibrosis (LS-8.0-14.0 kpa) and 99 (18.9%) patients had liver cirrhosis. It is concluded that transient elastography (TE) using Fibroscan is simple, non-invasive, reliable and easily reproducible method for assessing liver fibrosis and cirrhosis in patients with chronic HBV and HCV infection. TE is characterized with an excellent accuracy. TE results are well correlated with the clinical signs as well as with the results of laboratory and instrumental investigations. Fibrosis stages by Metavir measured using Fibroscan well corresponds with the liver biopsy results. Considering the high prevalence of fibrosis and cirrhosis among patients with chronic HBV and HCV infection, TE is a very valuable method for detecting early stages of fibrosis allowing to avoid the progression of liver damage, as well as end-stage liver disease. TE is easy to perform and therefore allows regular follow-up of the course of LF.