Determination of liver fibrosis stages in Egyptian chronic hepatitis B patients by a noninvasive tool

Turk J Med Sci. 2019 Aug 8;49(4):1145-1150. doi: 10.3906/sag-1812-165.

Abstract

Background/aim: Hepatitis B virus (HBV) infection is the leading cause of liver fibrosis (LF). The prognosis and management of patients with chronic hepatitis B virus depend on the amount and progression of liver fibrosis. Angiopoietin-like protein 2 (Angptl2) is not only a chronic inflammatory mediator, but also a tissue-remodeling factor. The aim of this study is to explore the predictive value of Angptl2 in different fibrosis stages in patients chronically infected with HBV.

Materials and methods: Eighty patients with chronic HBV infection undergoing Fibroscan were included. Serum concentrations of Angptl2 were detected using a commercial ELISA kit.

Results: Angptl2 levels were significantly associated with liver fibrosis stages (P = 0.02). The area under the curve (AUC) of Angptl2 for distinguishing patients who showed significant fibrosis (F2–F4) was70.2%. Angptl2 with fibrosis-4 (FIB-4) and Angptl2 with AST/platelets ratio (APRI) performed best with an AUC of 92.5%.

Conclusion: In patients with chronic HBV infection, Angptl2 level represents a potential biomarker independently associated with fibrosis stages. The combination of Angptl2 with FIB-4 or Angptl2 with APRI performed better than the existing models for diagnosing significant fibrosis.

Keywords: HBsAg; stage of fibrosis; angiopoietin-like protein 2; APRI; FIB-4.

MeSH terms

  • Adult
  • Angiopoietin-Like Protein 2
  • Angiopoietin-like Proteins / blood
  • Case-Control Studies
  • Egypt
  • Female
  • Hepatitis B, Chronic* / complications
  • Hepatitis B, Chronic* / diagnosis
  • Hepatitis B, Chronic* / epidemiology
  • Humans
  • Liver Cirrhosis* / classification
  • Liver Cirrhosis* / diagnosis
  • Liver Cirrhosis* / epidemiology
  • Liver Cirrhosis* / virology
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Severity of Illness Index

Substances

  • ANGPTL2 protein, human
  • Angiopoietin-Like Protein 2
  • Angiopoietin-like Proteins