Euroasian Journal of Hepato-Gastroenterology

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VOLUME 1 , ISSUE 2 ( July-December, 2011 ) > List of Articles

ORIGINAL ARTICLE

Evaluation of Fibrosis Progression by Noninvasive Biochemical Markers in Egyptian Patients with Chronic Hepatitis B

Tarek A Besheer, Mahmoud M El-Bendary, Khaled R Zalata, Hossam E Zaghalol

Citation Information : A Besheer T, M El-Bendary M, R Zalata K, E Zaghalol H. Evaluation of Fibrosis Progression by Noninvasive Biochemical Markers in Egyptian Patients with Chronic Hepatitis B. Euroasian J Hepatogastroenterol 2011; 1 (2):71-76.

DOI: 10.5005/jp-journals-10018-1016

License: CC BY-NC 4.0

Published Online: 01-07-2011


Abstract

Background: To evaluate the usefulness of biochemical markers for prediction of fibrosis in chronic hepatitis B. Materials and methods: This study was carried out on 133 patients with chronic hepatitis B. The diagnostic accuracy of four noninvasive liver fibrosis markers; matrix metalloproteinase-2 (MMP-2), hyaluronic acid (HA), aspartate aminotransferase (AST) to platelet ratio index (APRI) and FIB-4 was evaluated. Results: The levels of HA and MMP-2 were increased along with the severity of fibrosis. The cutoff value for HA was 265 ng/ml for predicting liver cirrhosis, whereas cutoff value for MMP-2 was 860 ng/ml. The cutoff value for APRI for detecting severe fibrosis (F3 and F4) was ≥ 0.9. Finally, cutoff value for FIB-4 was ≥ 0.9 for assessment of severe fibrosis in chronic hepatitis B. Conclusion: HA, MMP-2, APRI and FIB-4 could be clinically useful as noninvasive markers for detection of severe fibrosis in chronic hepatitis B.


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  1. Sandrin L, Tanter M, Gennisson JL, Catheline S, Fink M. Shear elasticity probe for soft tissues with 1-D transient elastography. IEEE Trans Ultrason Ferroelectr Freq Control 2002;49:436-46
  2. Therapeutic options for chronic hepatitis B: Considerations and controversies. Am J Gastroenterol 2006;101:S13-S18
  3. Update on viral hepatitis. Curr Opin Gastroenterol 2006;22:241-47
  4. Hepatic fibrosis. Schiff ER, Sorrell MF, Maddrey WC (Eds). In: Schiff’s diseases of the liver (10th ed). Philadelphia, New York 2006;371-83
  5. Liver biopsy. N Engl J Med 2001;344:495-500
  6. Treatment rates in patients with chronic hepatitis C after liver biopsy. J Viral Hepat 2006;13:783-86
  7. Noninvasive fibrosis biomarkers reduce but not substitute the need for liver biopsy. World J Gastroenterol 2006;12:3682-94
  8. An assessment of digital image analysis to measure fibrosis in liver biopsy specimens of patients with chronic hepatitis C. Am J Clin Pathol 2000;114:712-18
  9. Meta-analyses of fibrotest diagnostic value in chronic liver disease BMC. Gastroenterology 2007;7:40 [Online publication]
  10. Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C. Hepatology 1994;20:15-20
  11. Biopsy and noninvasive methods for the diagnosis of liver fibrosis: Does it take two to tango? Gut 2010;59:861-66
  12. Identification of chronic hepatitis C patients without hepatic fibrosis by a simple predictive model. Hepatology 2002;36:986-92
  13. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology 2003;38:518-26
  14. Staging of liver fibrosis in chronic hepatitis B patients with a composite predictive model: A comparative study. World J Gastroenterol 2010;16:501-07
  15. An algorithm for the grading of activity in chronic hepatitis C. The Metavir Cooperative study group. Hepatology 1996;24:289-93
  16. Ratio of serum aspartate to alanine aminotransferase in chronic hepatitis. Relationship to cirrhosis. Gastroenterology 1988;95:734-39
  17. Sequential algorithms combining noninvasive markers and biopsy for the assessment of liver fibrosis in chronic hepatitis B. World J Gastroenterol 2007;13:525-31
  18. Sampling variability of liver fibrosis in chronic hepatitis C. Hepatology 2003;38:1449-57
  19. Diagnostic value of serum markers of connective tissue turnover for predicting histological staging and grading in patients with chronic hepatitis C. J Gastroenterol 2001;36:399-406
  20. Expression of interleukin-17 in hepatitis B related liver fibrosis. Bao Xi, Fen Yu, Mianzi, Xue Yi, Zhi Za (Eds). 2009;25:133-35
  21. Clinical usefulness of serum matrix metalloproteinase-2 concentration in patients with chronic viral liver disease. J Hepatol 1999;30:1090-98
  22. Diagnostic accuracy of hyaluronan and type III procollagen aminoterminal peptide serum assays as markers of liver fibrosis in chronic viral hepatitis C evaluated by ROC curve analysis. Clin Chem 1996;42:558-63
  23. Clinical use of hyaluronic acid as a predictor of fibrosis change in hepatitis C. J Gastroenterol Hepatol 2003;18:253-57
  24. Serum hyaluronate as a noninvasive marker of hepatic fibrosis and inflammation in HBeAg-negative chronic hepatitis B. BMC Gastroenterol 2005;5:32[Online publication]
  25. Matrix metalloproteinase-2 activation in human hepatic fibrosis regulation by cell-matrix interactions. Hepatology 1999;30: 944-50
  26. Effect of oxymatrine on serum matrix metalloproteinase-2 and its inhibitor in patients with chronic hepatitis B and liver cirrhosis. Zhong Zhongguo, Yi Xi, He Jie, Zhi Za (Eds) 2005;25:989-92
  27. Plasma levels of matrix metalloproteinase-2 (MMP-2) and tissue inhibitors of metalloproteinase-1 and 2 (TIMP-1 and TIMP-2) as noninvasive markers of liver disease in chronic hepatitis C: Comparison using ROC analysis. Dig Dis Sci 1999; 44:624-30. Tarek A Besheer et al 76 JAYPEE 28. Boeker KH, Haberkorn CI, Michels D, Flemming P, Manns MP, Lichtinghagen R. Diagnostic potential of circulating TIMP- 1 and MMP-2 as markers of liver fibrosis in patients with chronic hepatitis C. Clin Chim Acta 2002;316:71-81
  28. Noninvasive assessment of liver fibrosis with combined serum aminotransferase/platelet ratio index and hyaluronic acid in patients with chronic hepatitis B. World J Gastroenterol 2008;14:7117-21
  29. Thrombocytopenia in liver disease. Can J Gastroenterol 2000;14:D60-D66
  30. Updated definitions of healthy ranges for serum alanine aminotransferase levels. Ann Intern Med 2002;137:1-10
  31. Liver biopsy: The best, not the gold standard. J Hepatol 2009;50:1-3
  32. Exceeding the limits of liver histology markers. J Hepatol 2009;50:36-41.
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