Assessment of Non-Invasive Biochemical Markers as a Predictive of Liver Fibrosis in Patients with Chronic Hepatitis B

Abstract

Background: Liver fibrosis is a complex fibrogenic and inflammatory processesthat results fromchronic liver injury and represents an early step in the progression of liver cirrhosis(Trivella et al., 2020).Generally liver fibrosis considered wound-healing process aimed at maintaining organ integrity and this development causes increase of laminin, collagen type III, collagen type IV and hyalouronate, these markers consider the main of extracellular matrix (Lambrecht et al., 2019). The aim of study: To study the fibrosis of liver in chronic hepatitis B patients by noninvasive direct and indirect biomarkers and evaluation the diagnostic efficiency of these biomarkers. Materials andMethods: A case control study, involves 119 participants:50 healthy persons as control and 69 patients with chronic hepatitis B, they were diagnosed by PCR technique. The direct biomarkers (serum laminin, collagen type IV, N-terminal peptide III collagen PIIINP, hyaluronate) and indirect markers (serum total bilirubin, direct bilirubin,aspartate aminotransferaseAST,alanine aminotransferaseALT, alkaline phosphataseALP, albumin and gamma glutamyltransferase(GGT), in addition to cholesterol were estimation by standard methods. Results: Comparison between control and HBV patients showed a significant difference (P.value<0.05) for liver function tests and fibrotic marker:laminin(33.12±5.65 control vs. 59.80±21.2 HBV),PIIINP(6.48±2.42 control vs.20.55±11.97 HBV),type IV collagen(18.97±10.04 control vs. 84.42±80.83 HBV),hyaluronate (32.68±15.29 control vs. 152.26±148.55 HBV).The sensitivity of fibrotic markers: laminin,PIIINP, type IV collagen and hyaluronateweremore than 80% when used the ROC curve. Conclusions: estimation of noninvasive biochemical markers could be detected fibrosis of liver in hepatitis B with significant accuracy. These biomarkers may use as alternative to liver biopsy and contributed to assessing the progression and treatment of liver fibrosis.