Body mass index (BMI) and alpha-fetoprotein (AFP) level correlate with the severity of HCV-induced fibrosis in a cohort of Egyptian patients with chronic HCV

Amal Ahmed Mohamed,Mohamed Salaheldin Abdel-Hakeem,Marwa Ali-Tammam,Amr Ali Hemeda,Ramy Karam Aziz

doi:10.1186/s43094-020-00085-3

Amal Ahmed Mohamed, Mohamed Salaheldin Abdel-Hakeem + Show 3 more

Open Access

https://doi.org/10.1186/s43094-020-00085-3

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Abstract

BackgroundViral hepatitis is the seventh leading cause of mortality globally, and half of this mortality is attributed to hepatitis C virus (HCV). Egypt has the highest HCV prevalence worldwide, with an estimated 14.7% of the population being HCV-positive. HCV infection is the primary cause of liver fibrosis, cirrhosis, and hepatocellular carcinoma. Liver fibrosis varies in severity during chronic HCV infection, and 10–20% of chronic hepatitis C (CHC) patients with severe fibrosis develop cirrhosis. The goal of this work was to assess the clinico-demographic predictors of severity of HCV-induced fibrosis in a cohort of Egyptian patients.ResultsA cohort of Egyptian patients with chronic HCV genotype 4a infection showed significant association between severe fibrosis stages and obesity, represented by a higher body mass index (BMI), low albumin level, high alpha-fetoprotein (AFP) level, low thyroid-stimulating hormone (TSH) level, and high alkaline phosphatase (ALP) level. Multivariate analysis delineated BMI, TSH, and ALP as independent significant variables that could predict the risk of fibrosis severity in HCV infections.ConclusionThis study argues in favor of using the biomarker profile of CHC patients infected with HCV genotype 4a to identify patients at higher risk of developing severe fibrosis, which is a necessary first step towards precision medicine via patient stratification.

Highlights

Viral hepatitis is the seventh leading cause of mortality globally, and half of this mortality is attributed to hepatitis C virus (HCV)
No significant difference was found in the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL), direct bilirubin (DBIL), blood glucose (BG), hemoglobin (Hb), creatinine (Cr), nor the platelet count and white blood cell (WBC) count (p > 0.05 for all parameters) between both groups
body mass index (BMI), albumin, thyroid-stimulating hormone (TSH), and alkaline phosphatase (ALP) were designated as significant predictors associated with the severe fibrosis in our study cohort

Summary

Introduction

Viral hepatitis is the seventh leading cause of mortality globally, and half of this mortality is attributed to hepatitis C virus (HCV). Egypt has the highest HCV prevalence worldwide, with an estimated 14.7% of the population being HCV-positive. HCV infection is the primary cause of liver fibrosis, cirrhosis, and hepatocellular carcinoma. Liver fibrosis varies in severity during chronic HCV infection, and 10–20% of chronic hepatitis C (CHC) patients with severe fibrosis develop cirrhosis. HCV infection is the primary cause of liver fibrosis, cirrhosis, and hepatocellular carcinoma (HCC) [3]. Egypt has the highest prevalence of HCV infection worldwide, with an estimated 14.7% of the population being HCV-positive [4, 5]. The main cause of this endemic is attributed to mass parenteral antischistosomal therapy campaigns in the 60s to 80s of the twentieth century [6]

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