BACKGROUND/AIMS: We evaluated whether surrogate serum biomarkers for liver injury are comparable to liver biopsy in Egyptian patients with hepatitis C virus (HCV) infection. SUBJECTS: Two hundred and twenty Egyptian patients, 91% infected with genotype-4 HCV, undergoing liver biopsy during evaluation for interferon/ribavirin therapy. METHODS: Liver biopsy scored by the Ishak method was compared to biochemical tests, platelet count and two fibrosis biomarkers: hyaluronic acid (HA) and YKL-40. Univariate and logistic regression analyses determined independent predictors of fibrotic, inflammatory, and fatty changes. Biomarkers were evaluated for ability to differentiate between severe fibrosis/cirrhosis and no/mild fibrosis. RESULTS: Although increasing age, HA, YKL-40, AST, reduced platelet count, and AST and HA/platelet count ratios were associated with fibrosis by univariate analysis, the other variables were not significant after controlling for HA (p=0.0001) and age (p=0.004). Although age and some biomarkers were associated with inflammation, none remained significant after controlling for fibrosis. YKL-40 (p=0.04) and aspartate aminotransferase (p=0.05) remained associated with steatosis after controlling for fibrosis. CONCLUSIONS: In Egyptians with chronic HCV, young patients with low levels of HA are at very low risk of fibrosis. This can limit the number of liver biopsies to those whose clinical findings conflict with the biomarker results.
BACKGROUND/AIMS: We evaluated whether surrogate serum biomarkers for liver injury are comparable to liver biopsy in Egyptian patients with hepatitis C virus (HCV) infection. SUBJECTS: Two hundred and twenty Egyptian patients, 91% infected with genotype-4 HCV, undergoing liver biopsy during evaluation for interferon/ribavirin therapy. METHODS: Liver biopsy scored by the Ishak method was compared to biochemical tests, platelet count and two fibrosis biomarkers: hyaluronic acid (HA) and YKL-40. Univariate and logistic regression analyses determined independent predictors of fibrotic, inflammatory, and fatty changes. Biomarkers were evaluated for ability to differentiate between severe fibrosis/cirrhosis and no/mild fibrosis. RESULTS: Although increasing age, HA, YKL-40, AST, reduced platelet count, and AST and HA/platelet count ratios were associated with fibrosis by univariate analysis, the other variables were not significant after controlling for HA (p=0.0001) and age (p=0.004). Although age and some biomarkers were associated with inflammation, none remained significant after controlling for fibrosis. YKL-40 (p=0.04) and aspartate aminotransferase (p=0.05) remained associated with steatosis after controlling for fibrosis. CONCLUSIONS: In Egyptians with chronic HCV, young patients with low levels of HA are at very low risk of fibrosis. This can limit the number of liver biopsies to those whose clinical findings conflict with the biomarker results.
Authors: Suzan El Naghi; Tawhida Y Abdel-Ghaffar; Hanaa El-Karaksy; Elham F Abdel-Aty; Mona S El-Raziky; Aleef A Allam; Heba Helmy; Hanaa A El-Araby; Behairy E Behairy; Mohamed A El-Guindi; Hatem El-Sebaie; Aisha Y Abdel-Ghaffar; Nermin A Ehsan; Ahmed M El-Hennawy; Mostafa M Sira Journal: World J Gastroenterol Date: 2014-04-28 Impact factor: 5.742
Authors: Samer S El-Kamary; Mona M Mohamed; Maissa El-Raziky; Michelle D Shardell; Olfat G Shaker; Wafaa A ElAkel; Gamal Esmat Journal: Liver Int Date: 2013-03-20 Impact factor: 5.828
Authors: Norihisa Nishimura; Davide De Battista; David R McGivern; Ronald E Engle; Ashley Tice; Rafaelle Fares-Gusmao; Juraj Kabat; Anna Pomerenke; Hanh Nguyen; Shinya Sato; Kevin W Bock; Ian N Moore; David E Kleiner; Fausto Zamboni; Harvey J Alter; Sugantha Govindarajan; Patrizia Farci Journal: Proc Natl Acad Sci U S A Date: 2021-04-27 Impact factor: 11.205