Accurate evaluation of the degree of
liver fibrosis in patients with chronic
liver diseases (CLD) is crucial, as
liver fibrosis is important in determining the prognosis of
liver diseases. Currently, liver biopsy (LB) is considered the gold standard for staging
liver fibrosis or
cirrhosis. However, utilization of LB in clinical practice is often limited because of its invasive nature, sampling error and interobserver variability. Recently, transient elastography (TE) was introduced as a noninvasive, highly reproducible technique for assessing the degree of
liver fibrosis. After extensive studies, TE is now regarded as a reliable
surrogate marker for grading the severity of
liver fibrosis in patients with CLD. In the past few years, the role of TE in monitoring liver stiffness and determining prognosis in patients with
chronic hepatitis B (CHB) or
chronic hepatitis C (CHC) who are undergoing
antiviral treatment has been investigated. In patients with CHB, liver stiffness values decrease with
antiviral treatment. TE can also be used to predict the incidence of liver-related events during
antiviral treatment. In patients with CHC, TE can be used to monitor potential regression of
liver fibrosis after
antiviral treatment and may predict the treatment outcome of CHC. In addition, TE is an adjunct tool for distinguishing inactive hepatitis B virus carriers from patients with
chronic active hepatitis. This review article discusses the important findings from recent studies focusing on the clinical application of TE in patients with chronic viral
hepatitis who are undergoing
antiviral treatments.