Liver status and metabolic-dysfunction associated steatotic liver disease/steatohepatitis presence by Fibroscan® in patients with chronic hepatitis B: A Faraday study

Background and Objectives: Evaluation of liver fibrosis is imperative in the management of chronic hepatitis B. Metabolic dysfunction-associated steatotic liver disease (MASLD) or metabolic dysfunction-associated steatohepatitis (MASH) with necroinflammation contribute significantly to liver damage. This study aims to investigate the role of vibration-controlled transient elastography (FibroScan®) as a non-invasive method for diagnosis and treatment follow-up. Methods: The study was prospectively planned in four different centers. Patients who were positive for hepatitis B surface antigen for more than 6 months and had an HBV-DNA > 2000 IU/mL underwent liver biopsy and FibroScan®. FibroScan® was performed before antiviral therapy and 1 year after treatment. Results: A total of 70 patients were included in the study. The mean age was 37.1 years, and 70.0% of the patients were male. The concordance rate with simultaneous elastography in 68 biopsies was 97.1% (P < 0.001). In 66 patients (97.0%), the liver fibrosis score was ≥ 2 or the hepatic activity index was ≥ 6. At the beginning of antiviral treatment, 19 patients (27.1%) had MASLD and 6 patients (8.6%) had MASH. The MASLD rate decreased to 25.7% (P = 0.064), and there was no change in MASH rate at the end of 1 year. The concordance rate with liver biopsy was found to be acceptable. Conclusion: FibroScan® was as useful as liver biopsy in the evaluation of chronic viral hepatitis-associated fibrosis as well as in the diagnosis and follow-up of concomitant MASLD/MASH.