To assess the value of transient elastography in assessing the effectiveness of antiviral drugs in chronic hepatitis B (CHB) patients by dynamically detecting the changes of liver hardness before and after antiviral therapy.

A total of 125 CHB patients who received lamivudine (LAM), adefovir (ADV), or LAM + ADV treatment at the First Affiliated Hospital of Anhui Medical University and the 901st Hospital of Joint Logistics Support Force form January 2015 to October 2019 were selected. Fibroscan values, alanine aminotransferase (ALT), and serum liver fibrosis indicators before and after (0~24 months) antiviral treatment were tested, and the results were compared by using one-way ANOVA. Pearson correlation coefficient was used to analyze the correlation of Fibroscan values with ALT and serum liver fibrosis indicators.

The patient's liver hardness values decreased significantly from (15.25±2.28) kPa before treatment to (6.79±1.76 kPa) 24 months after treatment (P＜0.001). Liver hardness values in the LAM group, ADV group, and LAM+ADV group were statistically different before treatment vs 6 months after treatment (t=5.597, 6.399, and 6.721, respectively, P＜0.001 for all), 12 months vs 6 months after treatment (t=4.779, 5.284, and 6.006, P＜0.001, =0.001, and <0.001, respectively), 18 months & 12 months after treatment (t=3.109, 3.456, and 3.638, P=0.003, =0.001, <0.001, respectively), and 24 months vs 12 months after treatment (t=2.801, 3.160, and 3.173, P=0.007, 0.002, and 0.002, respectively). After 24 months of treatment, the ALT recovery rate in the overall patient population reached 84.8% (106/125), and it was 83.78% (31/37) in the LAM group, 84.45% (38/45) in the ADV group, and 86.05% (37/43) in the LAM+ADV group. The values of serum hyaluronic acid (HA), laminin (LN), type Ⅲ procollagen (PC Ⅲ) and type Ⅳ collagen (Ⅳ C) decreased significantly after 24 months of treatment (LAM group: t=20.184, 5.312, 7.740, and 18.267, P＜0.001; ADV group: t=21.315, 3.361, 9.064, and 20.428, P＜0.001; LAM+ADV group: t=21.492, 7.158, 10.687, and 21.543, P＜0.001, respectively). Liver hardness values were positively correlated with ALT values and liver fibrosis index (HA, LN, PC Ⅲ , and Ⅳ C) values (r=0.745, 0.689, 0.695, 0.687, and 0.697, respectively, P＜0.05 for all).

Transient elastography can dynamically detect liver fibrosis in CHB patients, evaluate the efficacy of antiviral therapy, and have appreciated clinical application value.