Lab Med Online.  2019 Jul;9(3):153-160. 10.3343/lmo.2019.9.3.153.

Evaluation of Noninvasive Liver Fibrosis Blood Markers in Patients with Chronic Hepatitis B and Hepatitis C

• Lee JH
• Cho J
• Kim J
• Uh Y
• Youn KJ

• KMID: 2450840
• DOI: http://doi.org/10.3343/lmo.2019.9.3.153

Abstract

BACKGROUND
Liver fibrosis evaluation is an important issue in chronic liver disease patients. We aimed to develop noninvasive liver fibrosis biomarkers based on transient elastography (TE, FibroScan®) through retrospective review of clinicopathological data.
METHODS
We recruited 278 chronic hepatitis B patients who underwent Fibroscan and HBV DNA testing. A total of 115 HBeAg-positive and 159 HBeAg-negative chronic hepatitis B patients were analyzed. A total of 100 hepatitis C patients were analyzed. Successful fibroscan data, gamma-glutamyl transferase (GGT) to platelet ratio (GPR), platelet count, AST, ALT, international normalized ratio of prothrombin time, total cholesterol, triglycerides, bilirubin, mean platelet volume, AST to platelet ratio index, fibrosis index based on four factors (FIB-4), neutrophil to lymphocyte ratio (NLR), and NLR to platelet ratio were analyzed to determine the new noninvasive markers for assessing liver fibrosis.
RESULTS
Elevated GPR (OR=9.1, P=0.011) and FIB-4 (OR=2.3, P=0.01) were associated with greater risk of liver fibrosis in chronic hepatitis B patients. FIB-4 (OR=6.04, P=0.005) was a risk factor for liver fibrosis in HBeAg-positive patients. FIB-4 (OR=2.371, P=0.015) and GPR (OR=33.78, P=0.003) were liver fibrosis risk factor in HBeAg-negative patients. In chronic hepatitis C patients, GGT (OR=1.033, P=0.002), triglyceride (OR=−0.990, P=0.038) and FIB-4 (OR=3.499, P=0.006) showed statistical significances. The AUCs were 0.816 in FIB-4 (P<0.001) and 0.849 in GPR (P<0.001).
CONCLUSIONS
FIB-4 and GPR may be useful blood markers for assessing liver fibrosis in chronic hepatitis B and hepatitis C patients. Further well-designed prospective study is required to validate these noninvasive blood markers in clinical practice.

Keyword

Liver fibrosis; Hepatitis B; Hepatitis C; Fibroscan; Noninvasive marker

MeSH Terms

Area Under Curve
Bilirubin
Biomarkers
Blood Platelets
Cholesterol
DNA
Elasticity Imaging Techniques
Fibrosis
Hepatitis B
Hepatitis B, Chronic*
Hepatitis C*
Hepatitis C, Chronic
Hepatitis*
Hepatitis, Chronic*
Humans
International Normalized Ratio
Liver Cirrhosis*
Liver Diseases
Liver*
Lymphocytes
Mean Platelet Volume
Neutrophils
Platelet Count
Prospective Studies
Prothrombin Time
Retrospective Studies
Risk Factors
Transferases
Triglycerides
Bilirubin
Biomarkers
Cholesterol
DNA
Transferases
Triglycerides

Figure

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  Fig. 1. Box plot of gamma glutamyl transferase (GGT), platelet count, FIB-4 and GPR in chronic hepatitis B patients.

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  Fig. 2. Receiver operating characteristic (ROC) curve analysis of FIB-4 and GPR for the evaluation of liver fibrosis comparing transient elastography (fibroscan) results in chronic hepatitis B patients.

Reference

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