Abstract
BackgroundDue to no clinical symptoms in the compensated stage of cirrhosis, it is usually diagnosed when decompensated complications occur. In this study, the noninvasive circulating biomarkers for early detection to compensated stage of cirrhosis in patients with chronic HBV (hepatitis B virus) infection was explored.MethodsAccording to the Guideline of Prevention and Treatment of Chronic Hepatitis B (2015 Update), 78 patients with CHB (chronic hepatitis B) were divided into mild group, moderate-to-advanced group, while 73 patients with HBV-related cirrhosis were divided into compensated group and decompensated group. Nineteen cytokines and chemokines, four serum liver fibrosis markers were measured using chemiluminescence. The expression of CCL5 in liver tissue was determined with immunohistochemistry.ResultsThe CCL5 expression level in serum increased in CHB patients with aggravated liver injury and significantly decreased in cirrhosis patients with advanced liver fibrosis. ROC analysis revealed that the serum levels of CCL5, HA and MIP-1β were effective in distinguishing patients with cirrhosis from patients with CHB, especially for CCL5. Increasing serum level of CCL5 in CHB patients was severely associated with disease progression.ConclusionsThe serum levels of CCL5, HA and MIP-1β maybe used to distinguish cirrhosis from CHB patients, moreover, CCL5 was the most reliable marker. The increasing serum levels of CCL5 were significantly related to disease progression in CHB patients.
Highlights
Due to no clinical symptoms in the compensated stage of cirrhosis, it is usually diagnosed when decompensated complications occur
Compared with healthy check-up paticipants, except for Chemokine ligand 5 (CCL5) and Macrophage inflammatory protein-1 beta (MIP-1β) of Hepatitis B virus (HBV)-related cirrhosis patients, there was no difference for other inflammatory factors of Chronic hepatitis B (CHB) patients and HBV-related cirrhosis patients
The results indicated that the uptrend serum levels of Hyaluronic acid (HA), LN, Procollagen III N-terminal propeptide (PC-III) and Type IV collagen (C-IV) were worsened with disease progression, only the serum HA level of HBV-related liver cirrhosis showed a significant difference compared with healthy check-up paticipants and CHB patients (Table 1)
Summary
Due to no clinical symptoms in the compensated stage of cirrhosis, it is usually diagnosed when decompensated complications occur. The noninvasive circulating biomarkers for early detection to compensated stage of cirrhosis in patients with chronic HBV (hepatitis B virus) infection was explored. Which is named as cirrhosis, lead to end stage liver disease and portal hypertension [1]. The initial stage of HBV-related cirrhosis is asymptomatic, especially compensated cirrhosis stage, and disease progression has already developed to decompensated stage once some complications such as encephalopathy, spontaneous bacterial peritonitis, ascites, and variceal bleeding [2, 3]. The mortality of cirrhotic patients at the decompensated stage without liver transplant is as high as 85% over 5 years. In the USA, screening for cirrhosis from patients with chronic hepatitis C had previously been conducted
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