Prediction of fibrosis in hepatitis C patients: assessment using hydroxyproline and oxidative stress biomarkers.

This study aims to evaluate the diagnostic accuracy of aspartate aminotransferase (AST), alanine aminotransferase (ALT), hydroxyproline (Hyp), malondialdhyde (MDA), superoxide dismutase (SOD), and total antioxidant status (TAS) biomarkers in comparison with Metavir scoring for assessing the severity of hepatic fibrosis in the HCV patients. The histological activity index (HAI) was evaluated in liver biopsy by Metavir scoring system in 150 patients with HCV. HCV initial screening, further genotyping and biochemical data analysis were performed in serum using ELISA and biochemical assays. Out of the 150 HCV patients in this study, the most prevalent HCV genotype was genotype 4 (97 %). The significant fibrosis was estimated in 83.3 % of patients using the Metavir scoring system. They classified into 40 % of patients with mild fibrosis (F0-F1); 60 % with significant fibrosis (F2-4) and 20 % had cirrhosis (F4). Patients with cirrhosis (F4) showed significant correlation (P < 0.001) with increase in ALT, AST, AST/ALT, Hyp, Hyp/platelet count ratio, APRI, MDA, older age, and decrease (P < 0.001) in SOD, TAS, and platelet count compared to other stages of liver fibrosis. In our population, using optimized cut-off values of AST/ALT, APRI, Hyp, MDA, SOD, and TAS, significant fibrosis could be predicted accurately with a range of (80-90 %), and cirrhosis with a range of (67-97 %) of HCV patients. Our study showed that, oxidative stress and Hyp markers could be useful as noninvasive diagnostic markers in the assessment of hepatic fibrosis.