Diagnostic Role of Serum Golgi Protein 73 as a Biomarker for the Assessment of Significant Hepatic Fibrosis in Patients with Chronic Hepatitis B Infection

Abstract

Abstract Background Significant fibrosis is the hallmark of progressive nature of chronic HBV infection. Therefore, it is fundamentally important to detect significant fibrosis accurately for decision on subsequent clinical management. Liver stiffness (LS) determined with Transient elastography (TE) and non-invasive indirect serum biomarkers (APRI score and FIB-4 Index) are most promising approaches in non- invasively evaluating significant liver fibrosis and minimizing the need of invasive liver biopsy. A recently introduced fibrosis biomarker in chronic liver diseases is Serum Golgi protein 73 (GP73). Aim The current study aimed at assessing the diagnostic accuracy of serum GP73 for significant fibrosis in antiviral-naïve HBV patients. Methods Forty patients who have never been treated for HBV infection were enrolled. They were subjected to full history, clinical, laboratory assessment and imaging by abdominal ultrasound. Serum Golgi protein 73 level were assessed for all patients and compared with APRI score, FIB-4 index results. Results Out of 40 patients who were enrolled, 65% % were males. The mean age was 43.78±11.58 years. 11 patients (27.5%) had significant liver fibrosis (≥ F2) and 29 patients (72.5%) had “No or Mild Fibrosis (<F2) as evidenced by both APRI and FIB-4. Our study showed Statistically significant correlation between APRI score and FIB-4 Index with age of the patients, haemoglobin level, Platelets, albumin, AST level, ALT level, INR and Direct bilirubin levels with p value <0.001 for the age, AST, ALT, Platelets and Albumin, with p value <0.015 for haemoglobin and Direct bilirubin and with p value <0.005 for INR By using Pearson Correlation Coefficient. Serum biomarker GP 73 showed statistically significant correlation with Age in years (P <0.005), AST level (P <0.017), ALT level (P <0.022) and Platelets (P <0.002) and statistically insignificant correlation with Haemoglobin, albumin level, INR, and direct bilirubin level. Conclusions Noninvasive simple biomarkers FIB-4, APRI and measurements of GP 73 can be used as good predictor of liver fibrosis in antiviral-naïve chronic HBV patients which can minimize the need for invasive liver biopsy in prediction of significant hepatic fibrosis.