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Background/aims: The importance of identifying the stage of liver fibrosis has motivated the development of non-invasive methods. This study aimed to evaluate the applicability of ultrasound analysis involving the wave-number domain attenuation coefficient (W-Ac) in the non-invasive quantitative differentiation of liver fibrosis., Materials and Methods: This was a prospective study of inpatients with hepatitis B-related liver disease treated between October 2016 and January 2018. In ultrasound, the echo from the near-field liver tissue was selected as the reference signal. The W-Ac of liver tissues was based on the fast Fourier transform of the acquired post-beamforming radio frequency signals. These values were compared with fibrosis from biopsy METAVIR score results. A receiver operating characteristic (ROC) curve tested the W-Ac method., Results: A total of 46 patients were enrolled, including 27 males and 19 females. Fibrosis was stage F0 in 12 patients, F1 in 13 patients, F2 in 10 patients, F3 in 7 patients, and F4 in 4 patients. W-Ac increased with the progression of liver fibrosis up to stage F3. There were differences between F0 and F4 stages (p<0.001) and between any 2 stages of fibrosis (p<0.05), except for stages F3 and F4. There was a significant correlation between W-Ac and METAVIR score (r=0.795, p<0.001). W-Ac differed between non-fibrosis (F0) and fibrosis (F1-F4) groups (p<0.001) and in the normal (F0), early fibrosis (F1-2), and late fibrosis groups (F3-4) (p<0.001). ROC area under the curve was 0.890, and at a cut-off of 0.12153, sensitivity was 0.706 and specificity was 0.830., Conclusions: W-Ac allowed assessment of liver fibrosis in clinical practice.

Objective: To investigate the correlation between intrahepatic eovalently closed circular (ccc)DNA of hepatitis B virus (HBV) and pathogen-and patient-related parameters., Methods: Ultrasound-guided liver biopsies were obtained from 60 patients with chronic HBV infection. Levels of intrahepatic HBV cccDNA and serum HBV DNA were measured by quantitative fluorescence PCR. Level of serum hepatitis B surface antigen (HBsAg) was measured by chemiluminescence immunoassay. Clinical parameters, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (AKP), albumin, globulin (GLO), white blood cell, platelet, prothrombin-international normalized ratio, were measured by standard assay. Demographic information was recorded.The correlation between intrahepatic HBV cccDNA and pathogen-and patient-related parameters was assessed., Results: Intrahepatic HBV cccDNA level was negatively correlated with age, GLO, ALT and grade of necroinflammation. Patients with age of 30 years or more showed significantly higher level of HBV cccDNA level than patients under 30 years-old (7.44±0.58 and 5.66±1.35; t=7.157, P less than 0.001). Intrahepatic HBV cccDNA level was positively correlated with serum HBV DNA level (r=0.916, P less than 0.001) and serum HBsAg level (r=0.727, P less than 0.001). The median ratio of HBV cccDNA to HBV DNA was 1.18, and of HBV cccDNA to HBsAg was 1.67., Conclusion: Intrahepatic HBV cccDNA levels decrease with age, level of ALT, level of GLO and grade of liver necroinflammation, but increase with level of serum HBV DNA and level of serum HBsAg. To a certain extent, serum HBV DNA and serum HBsAg levels may be a sufficient marker of intrahepatic HBV cccDNA levels.