Abstract
Noninvasive serum markers for assessment of liver fibrosis in chronic hepatitis B (CHB) patients have not been well-studied. The present study was to evaluate the predictive value of serum interferon gamma-inducible protein-10 (IP-10/CXCL10) and the interferon (IFN)-γ/interleukin (IL)-4 ratio for liver fibrosis progression in CHB patients. A total of 180 CHB patients were categorized into four groups: no fibrosis, mild fibrosis, moderate fibrosis, and severe fibrosis. Serum and intrahepatic levels of IP-10, IFN-γ, and IL-4 were examined, from which the IFN-γ/IL-4 ratio was calculated. We found that the serum IP-10 levels were positively correlated with the severity of liver fibrosis, whereas the IFN-γ/IL-4 ratio was negatively associated with the progression of hepatic fibrosis. Multivariate logistic regression analysis revealed that the serum IP-10 was an independent predictor for significant fibrosis. For predicting significant fibrosis, the IP-10 cut-off value of 300 ng/mL had a sensitivity of 92.7% and a specificity of 68.6%. When the IP-10 level was combined with the IFN-γ/IL-4 ratio, the specificity and positive predictive value were 93.8% and 94.6%, respectively; thus, the discriminatory ability was much improved. In conclusion, the serum IP-10 level and the IFN-γ/IL-4 ratio have great potential to predict significant fibrosis among CHB patients.
Highlights
Chronic hepatitis B virus (HBV) infection is one of the major causes of serious liver diseases, including liver cirrhosis and hepatocellular carcinoma (HCC), through a complicated course with fibrosis as a middle essential stage[1,2,3]
Statistical analysis indicated that ALT, AST, total bilirubin (TBil), prothrombin time (PT), and International normalized ratio (INR) were significantly higher in all fibrotic groups compared with the controls (F0), with the highest values observed in the F5–6 group; whereas
Our results suggest that the serum inducible protein-10 (IP-10) level and the IFN-γ/IL-4 ratio are able to predict significant fibrosis among chronic hepatitis B (CHB) patients (Fig. 2 and 3)
Summary
Chronic hepatitis B virus (HBV) infection is one of the major causes of serious liver diseases, including liver cirrhosis and hepatocellular carcinoma (HCC), through a complicated course with fibrosis as a middle essential stage[1,2,3]. Liver biopsy has traditionally been considered as the gold standard for assessment of hepatic fibrosis in chronic hepatitis B (CHB) patients[4], but it is an invasive procedure with several limitations such as sampling errors and intra- and inter-observer variability This technique has recently been challenged by the development of several novel noninvasive tests, relying on quantification of serum markers of liver fibrosis, measurement of liver stiffness by imaging techniques, or the combination of these two approaches. Most of the evaluations of serum markers have been performed in patients with chronic hepatitis C virus (HCV) infection, whereas there were only limited data on the serum markers for the early detection and diagnosis of HBV-related fibrosis. The aim of this study was to evaluate the predictive value of the IP-10 level alone or in combination with the IFN-γ/IL-4 ratio for liver fibrosis progression in patients with chronic HBV infection
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