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.
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.
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
Therapeutic options for chronic hepatitis B: Considerations and controversies. Am J Gastroenterol 2006;101:S13-S18
Update on viral hepatitis. Curr Opin Gastroenterol 2006;22:241-47
Hepatic fibrosis. Schiff ER, Sorrell MF, Maddrey WC (Eds). In: Schiff’s diseases of the liver (10th ed). Philadelphia, New York 2006;371-83
Liver biopsy. N Engl J Med 2001;344:495-500
Treatment rates in patients with chronic hepatitis C after liver biopsy. J Viral Hepat 2006;13:783-86
Noninvasive fibrosis biomarkers reduce but not substitute the need for liver biopsy. World J Gastroenterol 2006;12:3682-94
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
Meta-analyses of fibrotest diagnostic value in chronic liver disease BMC. Gastroenterology 2007;7:40 [Online publication]
Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C. Hepatology 1994;20:15-20
Biopsy and noninvasive methods for the diagnosis of liver fibrosis: Does it take two to tango? Gut 2010;59:861-66
Identification of chronic hepatitis C patients without hepatic fibrosis by a simple predictive model. Hepatology 2002;36:986-92
A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology 2003;38:518-26
Staging of liver fibrosis in chronic hepatitis B patients with a composite predictive model: A comparative study. World J Gastroenterol 2010;16:501-07
An algorithm for the grading of activity in chronic hepatitis C. The Metavir Cooperative study group. Hepatology 1996;24:289-93
Ratio of serum aspartate to alanine aminotransferase in chronic hepatitis. Relationship to cirrhosis. Gastroenterology 1988;95:734-39
Sequential algorithms combining noninvasive markers and biopsy for the assessment of liver fibrosis in chronic hepatitis B. World J Gastroenterol 2007;13:525-31
Sampling variability of liver fibrosis in chronic hepatitis C. Hepatology 2003;38:1449-57
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
Expression of interleukin-17 in hepatitis B related liver fibrosis. Bao Xi, Fen Yu, Mianzi, Xue Yi, Zhi Za (Eds). 2009;25:133-35
Clinical usefulness of serum matrix metalloproteinase-2 concentration in patients with chronic viral liver disease. J Hepatol 1999;30:1090-98
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
Clinical use of hyaluronic acid as a predictor of fibrosis change in hepatitis C. J Gastroenterol Hepatol 2003;18:253-57
Serum hyaluronate as a noninvasive marker of hepatic fibrosis and inflammation in HBeAg-negative chronic hepatitis B. BMC Gastroenterol 2005;5:32[Online publication]
Matrix metalloproteinase-2 activation in human hepatic fibrosis regulation by cell-matrix interactions. Hepatology 1999;30: 944-50
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
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
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
Thrombocytopenia in liver disease. Can J Gastroenterol 2000;14:D60-D66
Updated definitions of healthy ranges for serum alanine aminotransferase levels. Ann Intern Med 2002;137:1-10
Liver biopsy: The best, not the gold standard. J Hepatol 2009;50:1-3
Exceeding the limits of liver histology markers. J Hepatol 2009;50:36-41.
