Prediction of Hepatic Fibrosis in Patients with Chronic Hepatitis C Genotype 4:  A non-Invasive biochemical analysis

Amr Amin¹,^2*, Mohammed Mukhtar¹, Essam Noor Eldin¹, Fahd Gethami³, Fayez Hafez³, Sameer Fatani¹, Neda Bogari⁴, Mohammed Noor Eldin¹,²,  Abdullatif  Babakr¹, Soud Khogeer¹and Ahmed Fawzy^5*

¹Biochemistry Department, Faculty of Medicine, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia. ²Oncology Diagnostic Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt. ³King Faisal Hospitals, Shesha, Makkah, Kingdom of Saudi Arabia. ⁴Medical Genetics department, Faculty of Medicine, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia. ⁵Division of Human Genetics and Genome Research, Department of Molecular Genetics and Enzymology, National Research Centre, 33Bohouth St. Dokki, Giza, Egypt Corresponding Author's Email:  aaamin@uqu.edu.sa

DOI : http://dx.doi.org/10.13005/bbra/2032

ABSTRACT: Hepatic fibrosis detection is considered as a major independent predictor of treatment response in patients with chronic hepatitis C virus (HCV). Liver biopsy was represented as the gold standard method for evaluating liver fibrosis and has prone sampling errors and completions. Right now, usages of non-invasive predictors of fibrosis are considered less accurate than liver biopsy. We are aiming to reduce the use of the liver biopsy and instead evaluate the performance value of serum hyaluronic acid (HA), Collagen type IV (Coll-IV), and aspartate aminotransferase (AST) to platelet ratio index (APRI) as non-invasive diagnostic and stratification markers for hepatic fibrosis. In this study, we have recruited 104 subjects from Saudi population effected with chronic hepatitis C genotype 4. The enzyme-linked immunosorbent assay (ELISA) method was implemented for Liver histopathological staging (F), serum hyaluronic acid and Collagen-IV. APRI was calculated from serum AST activity and platelet count. The results of our current study indicated both Collagen-IV and APRI significantly distinguished fibrotic patients from non-fibrotic group. The HA, APRI, and Coll-IV results discriminate early F0/F1 from F2/F3 (p<0.001). A combination of direct and indirect tests (Coll-IV and APRI) improved the performance with sensitivity and specificity. The combination of APRI and Collagen-IV has a high diagnostic value in predicting moderate and severe fibrotic stages and could be clinically used as a diagnostic test especially for those HCV patients who could not be submitted for liver biopsy.

KEYWORDS: Hepatic fibrosis; chronic hepatitis C; HCV genotype 4; serum hyaluronic acid (HA); serum Collagen type IV (Coll-IV); AST to platelet ratio index (APRI); Receiver operating characteristics

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