Influence of Meal Intake on Liver Stiffness in Patients with Chronic Hepatitis B and C

Warisara Tangpradabkiet MD*, Surat Praneenararat MD*, Naichaya Chamroonkul MD*, Teepawit Witeerungrot MD**, Teerha Piratvisuth MD**

Affiliation : * Division of Gastroenterology, Department of Medicine, Prince of Songkla University, Songkhla, Thailand ** NKC Institute of Gastroenterology and Hepatology, Prince of Songkla University, Songkhla, Thailand

Background : Transient elastography (TE) is a non-invasive test for evaluation of fibrosis in chronic hepatitis B (CHB) and chronic hepatitis C (CHC). Meal intake has been found to affect liver stiffness (LS) values in CHC patients, but there is still lack of data in CHB patients.
Objective : Evaluate the influence of meal intake on LS values by TE in non-cirrhotic CHB patients and compare its effect with non-cirrhotic CHC patients. Material and Method: Forty-five CHB patients and 37 CHC patients were included. LS measurements by TE were done at three different times including 4-hour fasting, immediately, and 60 minutes after finishing 500 kcal meal.
Results : Mean fasting LS values in CHB patients were 5.401.7 kPa. LS values in CHB patients significantly increased at both immediately and 60 minutes after finishing meal by 0.310.1 kPa (p = 0.035) and 0.330.1 kPa (p = 0.018), respectively. Difference in the peak changes of LS values after meal were not significant between CHB and CHC patients (CHB 0.720.1 vs. CHC 1.160.1, p = 0.076). No other variables associated with the changes of LS values after meal in either CHB patients or CHC patients.
Conclusion : Meal intake significantly increases LS values in CHB and CHC patients. It was considered to be a confounding factor in LS measurements. An appropriate time of fasting should be done before LS measurement in both CHB and CHC patients.

Keywords : Meal, Liver stiffness, Transient elastography, Chronic hepatitis B, Chronic hepatitis C

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