Hepatocellular Regeneration and Necrosis Markers in Chronic HCV Patients under Sofosbuvir-Based Regimen

Abstract

Objectives: To evaluate noninvasive fibrosis markers, retinol binding protein 4 (RBP4), and alpha-feto protein (AFP) in foreseeing liver fibrosis in persistent hepatitis C patients and their correlations with Fibroscan. Materials and Method: Fifty naive CHC patients and 20 healthy age and sex-matched subjects as controls were included. Blood samples and fibroscan obtained before and 3 months after treatment with DAAs for CBC, INR, and Liver function tests, RBP4, AFP and different fibrosis markers as APRI, CDS, FIB-4, GUCI, Lok index. Results: All patients achieved SVR (12 weeks) with an change of liver function and decrease of liver fibrosis as measured by Fibroscan. The Fib-4 score gave the best performance and diagnostic accuracy for the prediction of the presence of significant fibrosis, then (APRI and GUCI) followed by the CDC and LOK index; and lastly RBP4 as they were efficient to differentiate significant fibrosis (moderate and severe) liver scarring (F2-F3) from mild fibrosis (F0-F1). However; the accuracy of RBP4 improved with a higher fibrosis grade and thus can differentiate the presence or absence of severe (F3-F4) from mild & moderate (F1-F2) liver scarring with 93.75% for PPV and NPV but with a poor prediction of the absence of significant fibrosis (F1 versus F2–F3), while LOK score was excellent in the prediction of the absence of significant fibrosis (F1 versus F2–F3). Conclusions: FIB-4, APRI, GUCI, CDS, and Lok index were accurate to predict the fibrosis grade in CHC patients, correlated with hepatic injury and can assess DAAs treatment success.