DIFFERENT SERUM FIBROSIS BIOMARKERS AS MONITORING TOOLS FOR DETECTING FIBROSIS REGRESSION IN TREATED HCV PATIENTS Mohamed Alboraie1, Mohamed El Kassas2, Ahmad Sweedy3, Mohamed Nour4, and Egyptian liver fibrosis study group1
1
Department of Internal Medicine, Al-Azhar University, 2Department of Endemic Medicine and Hepatology, Helwan University, Cairo, 3Damietta Cardiology and Gastroenterology Center, Damietta, Egypt, 4Faculty of Public Health & Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
Introduction Treating chronic hepatitis C (CHC) is associated with improving long-term outcomes and health-related quality of life. Monitoring fibrosis regression in response to treatment is important to identify patients with residual cirrhosis after CHC cure as they need longterm surveillance for hepatocellular carcinoma (HCC). Due to limitations of repeating liver biopsy after treatment; surrogate biomarkers can be an alternative to monitor fibrosis regression and to identifying patients with residual cirrhosis.
Objectives
their values in the control group (table 1). FIB-4 and Fibro-alpha had increase in their values in the control group but this was not significant. There were no other significant changes in the values of the studied panels in other treatment groups.
Table (1): Week zero and week 72 values of different biomarker panels among group 1 (SVR) and groups 5 (control) patients.
We aimed at monitoring regression of fibrosis in a group of CHC patients in response to treatment by calculating six different panels (APRI, FIB-4, PLASA, FRT, Fibro-alpha and BRC) used as non-invasive markers of hepatic fibrosis.
Materials & Methods Data of 363 CHC patients (140 males) were retrospectively analyzed. Data included pretreatment and post treatment laboratory parameters according to the national guidelines for treating CHC in Egypt (2007-2014). Patients were classified into 4 groups according to treatment response; patients who had sustained virologic response (group 1; n =90), relapsers after treatment (group 2; n =65), patients who had breakthrough during treatment (group 3; n =12) and null responders (group 4; n =71) in addition to a control groups (group 5; n = 125) of CHC patients whom were in eligible or refusing to receive standard of care treatment. All treated patients received pegylated interferon and ribavirn combination. APRI, FIB-4, PLASA, FRT, Fibro-alpha and BRC were calculated at weeks 0 and 72 for all groups and correlated to fibrosis stage by METAVIR and to treatment outcome in different groups.
Conclusions All of the studied biomarker panels for liver fibrosis assessment were useful in monitoring regression of fibrosis in treated CHC patients and most of them were useful in monitoring progression of fibrosis in untreated patients
Correspondence to: Dr. Moahemd Alboraie
Results APRI, FIB-4, PLASA, FRT, Fibro-alpha and BRC could predict significant hepatic fibrosis (≥F2 METAVIR), advanced hepatic fibrosis (≥F3 METAVIR) and cirrhosis (F4 METAVIR) accurately. All panels showed significant decrease of their values in group 1 (sustained virologic response) in response to treatment. On the contrary; APRI, PLASA, FRT and BRC showed significant increase of
Department of Internal Medicine, Al-Azhar University, Cairo 11651, Egypt. E-Mail:
[email protected] *Non -significant difference. SVR: Sustained virologic response
