Assessment of Von Willebrand Factor in Hepatitis C Patients as Biomarker for Liver Fibrosis and Predictor of HCC

Abstract

Background:Hepatitis C virus (HCV) infection is a progressive disease that may result in chronic active hepatitis, cirrhosis, and hepatocellular carcinoma. Itis estimated that about 160 million individuals are chronically infected with HCV. Hepatocellular carcinoma (HCC), the fifth most common cancer in men and the ninth in women, represents an urgent clinical problem, being the second leading cause of cancer-related death worldwide. Aim of the study: To determine whether VWF is a potential biomarker for liver fibrosis in comparison to other markers of fibrosis and predictor for development of Hepatocellular Carcinoma in comparison with Alpha-feto protein and Des Gamma carboxy prothrombin. Patients and Methods: This study had been carried out on 50 subjects, age range 34-77 year selected from Virology and Hepatology outpatient clinics at Ain shams university hospitals in Cairo after informed consent were taken from the patients. Subjects were divided as follows: Group I: Include 20 HCC patients diagnosed by imaging and alpha- fetoprotein. Group II: Include 20 matched cirrhotic patients without HCC divided according to child – pugh scoring system. Group III: Include 10 apparently healthy subjects, age and sex matched, having no acute or chronic illness and taking no medications were taken as control group. Results: In our study, VW factor was statistically significant higher in cirrhotic patients than control group and in patients with HCC than cirrhotic group without HCC, with weak positive correlation with other markers of liver fibrosis (FIB4, APRI), and weak positive correlation with other markers of hepatocellular carcinoma (alpha feto protein, des gamma carboxy prothrombin). VW factor was statistically significant higher in advanced stages of liver cirrhosis. Conclusion:In conclusion; VWfactor is statistically significant higher in patients with Hepatocellular carcinoma than in cirrhotic patients without HCC. There is weak positive correlation between VW factor as a biomarker for liver fibrosis and other scores assessing stage of fibrosis. There is a strong correlation between VW factor and child score used to classify stage of liver cirrhosis, so VW factor is valuable predictor for hepatocellular carcinoma and advanced stages of liver cirrhosis. Background:Hepatitis C virus (HCV) infection is a progressive disease that may result in chronic active hepatitis, cirrhosis, and hepatocellular carcinoma. Itis estimated that about 160 million individuals are chronically infected with HCV. Hepatocellular carcinoma (HCC), the fifth most common cancer in men and the ninth in women, represents an urgent clinical problem, being the second leading cause of cancer-related death worldwide. Aim of the study: To determine whether VWF is a potential biomarker for liver fibrosis in comparison to other markers of fibrosis and predictor for development of Hepatocellular Carcinoma in comparison with Alpha-feto protein and Des Gamma carboxy prothrombin. Patients and Methods: This study had been carried out on 50 subjects, age range 34-77 year selected from Virology and Hepatology outpatient clinics at Ain shams university hospitals in Cairo after informed consent were taken from the patients. Subjects were divided as follows: Group I: Include 20 HCC patients diagnosed by imaging and alpha- fetoprotein. Group II: Include 20 matched cirrhotic patients without HCC divided according to child – pugh scoring system. Group III: Include 10 apparently healthy subjects, age and sex matched, having no acute or chronic illness and taking no medications were taken as control group. Results: In our study, VW factor was statistically significant higher in cirrhotic patients than control group and in patients with HCC than cirrhotic group without HCC, with weak positive correlation with other markers of liver fibrosis (FIB4, APRI), and weak positive correlation with other markers of hepatocellular carcinoma (alpha feto protein, des gamma carboxy prothrombin). VW factor was statistically significant higher in advanced stages of liver cirrhosis. Conclusion:In conclusion; VWfactor is statistically significant higher in patients with Hepatocellular carcinoma than in cirrhotic patients without HCC. There is weak positive correlation between VW factor as a biomarker for liver fibrosis and other scores assessing stage of fibrosis. There is a strong correlation between VW factor and child score used to classify stage of liver cirrhosis, so VW factor is valuable predictor for hepatocellular carcinoma and advanced stages of liver cirrhosis.