Assessment of Liver Fibrosis in HCV Infection in Egyptian Patients

One trial to replace liver biopsy with a simple blood test(s) (whose levels can reflect the severity of liver disease) is the aim of this work. The present investigation was carried out on 72 cases (62 fibrotics and 10 hepatocellular carcinomas; HCCs) who referred to the Early Cancer Detection Unit belonging to the Faculty of Medicine, Zagazig University, Egypt for liver biopsy assessment. Their sera were tested for liver enzymes (alanine aminotrasferase {[}ALT], aspartate aminotransferase {[}AST] and AST/ALT ratio), HCV viraemia and type, matrix metalloproteinase-9 (MMP-9) and alpha fetoprotein (AFP). The relationships between the values of these serum tests and the stages of liver fibrosis or the presence of HCC were studied in this work. The results indicated that, the serum ALT level at 60 U/L was indicative of significant fibrosis in 81\%. Serum AST level at 130 U/L was indicative of significant fibrosis in 88\%. However, the transaminases levels can't differentiate, at any level between cancerous and non-cancerous lesions. The transaminases ratio (AST/ALT) at a cut off value 1.0 reflected significant fibrosis in 93\% of patients but can't differentiate between cancerous and non-cancerous lesions. Similarly, the serum level of MMP-9 was diagnostic at a level of 160 mg/dl or less for severe fibrosis in 87\% of patients but not for HCC. On the other hand, the level of AFP at 1000 ng/ml or more was diagnostic for cancerous lesions in 90\% of patients but cannot differentiate at any level between mild and significant fibrosis. Unfortunately, the HCV level of viraemia and type did not affect the severity of liver disease. The age of patient at the biopsy was found to correlate positively with liver disease. The significant fibrosis was found in 81\% of patients aged 45 years or more. While, at a cut off value of 55 years, age at the biopsy was diagnostic for HCCs in 88\% of patients with a specificity of 71\%. On the other hand, the sex of the patient had no effect on severity of liver disease. In conclusion, there is no single blood test whose value can predict the severity of liver diseases in HCV infection with 100\% accuracy, but the use of the above significant serum parameters together with age of the patient can help to exclude the need for liver biopsy in many patients, at least those with contraindications for liver biopsy or those refuting this investigation. {[}Samia, M. Sanad, Amal, M. Mangoud, Ahmed A. Hendawy and Gaber E. Saadon Assessment of Liver Fibrosis in HCV Infection in Egyptian Patients. Life Science Journal 2011; 8(4): 1097-1117]. (ISSN: 1097-8135). http://www.lifesciencesite.com.136