Abstract

Background & Aims: The gamma-glutamyl transpeptidase (GGT) to platelet ratio (GPR), the gamma-glutamyl transpeptidase to albumin (GAR) and S-index are novel biomarkers suggested to assess liver fibrosis. The aim of the work was to assess the correlation between GGT and other related markers as GAR and GPR among other previous documented markers and the degree of fibrosis and steatosis in chronic HBV Egyptian patients as measured by fibroscan. Materials And Methods: After ethical approval of the protocol, a total of 170 chronic HBV patients were recruited from tropical medicine department, Tanta University. They underwent fibroscan examination for fibrosis and steatosis measurement with concomitant testing of liver functions and complete blood picture. Proposed serum markers were calculated. The relation between these ratios with the fibrosis and steatosis measured by fibroscan were tested using Pearson rank correlation. Results: There was a highly significant positive correlation between gamma-glutamyl transpeptidase and platelet ratio (GPR), GAR, GGT, Fib4, APRI and fibrosis (p=<0.001, <0.001,<0.001,<0.001,0.011 and <0.001 respectively), while there was no correlation with the degree of steatosis (p=0.922,0.66,0.936,0.214,0.591 and 0.760 respectively). Also these markers were significantly higher in patients with higher grades of fibrosis (f2-4) (p= 0.007,0.013,<0.001,0.018,0.029,and 0.002 respectively), they also showed high sensitivity and low specificity in detecting higher grades of fibrosis with no statistically significant difference between the AUC of GPR and GAR (p=0.89). Conclusion: Noninvasive serum markers including GGT, GPR, GAR, Fib4, APRI, and S-index are positively correlated to the degree of fibrosis in CHB patients with high sensitivity and low specificity. They were good negative tests for diagnosis of significant fibrosis.

Highlights

  • Hepatitis B virus (HBV) infection is a challenging health problem

  • There was a highly significant positive correlation between gamma-glutamyl transpeptidase and platelet ratio (GPR), glutamyl transpeptidase to albumin (GAR), GGT, Fib4, APRI and fibrosis (p=

  • These markers were significantly higher in patients with higher grades of fibrosis (f2-4) (p= 0.007,0.013,

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Summary

Introduction

Hepatitis B virus (HBV) infection is a challenging health problem. According to the World Health Organization, an estimated 240 million individuals (3.7%) suffered from chronic HBV infection worldwide [1]. In 2016, Lemoine and colleagues presented a simple marker of liver fibrosis depending on the gammaglutamyl transpeptidase and platelet ratio (GPR) as a marker for diagnosing liver fibrosis in patients with chronic (HBV) infection in West Africa [9]. While another study presented GGT to albumin ratio (GAR) as another marker for diagnosing liver fibrosis in CHB [10]. The gamma-glutamyl transpeptidase (GGT) to platelet ratio (GPR), the gamma-glutamyl transpeptidase to albumin (GAR) and S-index are novel biomarkers suggested to assess liver fibrosis. The aim of the work was to assess the correlation between GGT and other related markers as GAR and GPR among other previous documented markers and the degree of fibrosis and steatosis in chronic HBV Egyptian patients as measured by fibroscan

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