Abstract
Background: Hepatitis B virus and Hepatitis C virus infection is one of the public health problems in Egypt. So we aimed to evaluate the efficacy of serum osteopontin as predictor of hepatic fibrosis regression and virological response in patients with chronic HBV or HCV infection. Methods: This study has been conducted on 74 HBeAg + ve chronic HBV infection, 74 chronic HCV infection and 74 healthy controls. HBV patients treated with Entecavir. HCV patients treated with sofosbuvir, daclatasvir with or without ribavirin. One year post HBeAg seroconversion and 3 months after end of regular antiviral treatment for patients with chronic HBV and chronic HCV infection respectively, hepatic condition was reevaluated. Results: 14.9% of patients with HBV, failed to achieve undetectable HBV DNA or HBeAg seroconversion and 2.7% of patients with HCV infection, failed to achieve SVR. In chronic HBV, pretreatment high serum osteopontin predict failure of virological response and hepatic fibrosis regression at a cutoff > 115.5, with 90.91% sensitivity, 82.54% specificity. Also high degree of liver stiffness predicts failure of hepatic fibrosis regression at a cutoff > 8.7, with 81.8% sensitivity, 73% specificity. Conclusions: In chronic HBV infection low osteopontin predicts good virological response and hepatic fibrosis regression. But it has no role in predicting SVR or hepatic fibrosis regression in chronic HCV infected patients.
Highlights
We aimed to evaluate the efficacy of serum osteopontin as predictor of hepatic fibrosis regression and virological response in patients with chronic Hepatitis B virus (HBV) or hepatitis C virus (HCV) infection
The side effects reported post treatment with sofosbuvir, daclatasvir, and ribavirin combination range from mild adverse events as anemia, fatigue, headache, and itching to severe side effects as hepatocellular carcinoma and hepatic encephalopathy which reported in patients with advanced liver disease [5]
The present study included 222 subject classified to 3 groups, the first group include 74 apparent healthy control, the second group include 74 naive chronic HBV infected patient with their mean ages were 50.4 ± 9.1; 35 (47.3%) females and 39 (52.7%) males of them 25 (33.8%) had mild viral load, 25 (33.8%) had moderate viral load and 24 (32.4%) had high viral load
Summary
Egypt has the highest prevalence of hepatitis C virus (HCV) infection worldwide [1].Chronic hepatitis C virus infection is the main cause of end-stage liver disease with liver cirrhosis and hepatocellular carcinoma in Egypt, it’s responsible for chronic hepatitis in about 80% of the infected patients, of them about 20% develop liver cirrhosis of them about 6% develop decompensated liver disease and 5% of the patients with liver cirrhosis develop hepatocellular carcinoma [2].Sofosbuvir, daclatasvir, with or without ribavirin combination are safe and effective in treatment of chronic hepatitis C virus infection in Egypt [3].Sustained virological response after 3 months of regular treatment achieved in about 95% of patients in the easy-to-treat group who received Sofosbuvir and daclatasvir, and reach about 92% in the difficult-to-treat group who treated with Sofosbuvir, daclatasvir, and ribavirin [3].Direct acting antiviral (DAA) combinations proved to cause obvious improvements in hepatic laboratory parameters with good clinical outcomes in chronic hepatitis C virus treated patients [4].The side effects reported post treatment with sofosbuvir, daclatasvir, and ribavirin combination range from mild adverse events as anemia, fatigue, headache, and itching to severe side effects as hepatocellular carcinoma and hepatic encephalopathy which reported in patients with advanced liver disease [5]. Sofosbuvir, daclatasvir, with or without ribavirin combination are safe and effective in treatment of chronic hepatitis C virus infection in Egypt [3]. One year post HBeAg seroconversion and 3 months after end of regular antiviral treatment for patients with chronic HBV and chronic HCV infection respectively, hepatic condition was reevaluated. In chronic HBV, pretreatment high serum osteopontin predict failure of virological response and hepatic fibrosis regression at a cutoff > 115.5, with 90.91% sensitivity, 82.54% specificity. Conclusions: In chronic HBV infection low osteopontin predicts good virological response and hepatic fibrosis regression. It has no role in predicting SVR or hepatic fibrosis regression in chronic HCV infected patients
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