Research Article
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The Value of Indirect Biomarkers in the Monitoring of Hepatitis C Virus Infection at the Mogadishu Hospital, Somalia

Year 2022, Volume: 6 Issue: 2, 158 - 164, 31.08.2022
https://doi.org/10.29058/mjwbs.1100914

Abstract

Aim: We aimed to investigate the value of Class II fibrosis markers as predictors of liver disease
progress, and changes in platelet parameters in the laboratory tests of patients with Hepatitis C virus
infection [anti-HCV (+)]admitted to the Somalia Mogadishu Hospital.
Material and Methods: All patients older than 18 years old, who were examined in our hospital’s
were included in the study. Accompanied by CBC and biochemical measurement results from patients,
indirect liver fibrosis (Class II) markers AAR (AST/ALT ratio), APRI (AST/Plt ratio index) and FIB-4
index (Age (year) x AST (U/L) / [Platelet count (109 / L)] x (ALT) 1/2 (U / L)], MPV/Platelet ratio, APRI =
[(person AST/AST reference upper limit) x Platelet (103 /ml) x 100] were calculated.
Results: A total of 2,887 patients, 1,605 (55.6%) male and 1,282 (44.4%) female, with a median age
of 51 (32-67) years, were included in our study. The anti-HCV positivity rate was found to be 1.5 times
higher in men than women.APRI, MPV / Plt R and RPR levels, indirect markers of liver damage, were
found to be higher in patients with anti-HCV (+) than those in the control group (p<0.001).The median
FIB-4 value of anti HCV (+) patients was found to be 1.94 (0.07-297.41).
Conclusion: We think that APRI, MPR, the MPV/Plt ratio and FIB-4 biomarkers in particularare useful
tests in indicating fibrosis and in predicting its severity in patients with anti-HCV (+) in the Sub-Saharan
Africa region.

References

  • 1. Averhoff FM, Glass N, Holtzman D. Global Burden of Hepatitis C: Considerations for Healthcare Providers in the United States. Clin Infect Dis. 2012 Jul 15;55(suppl_1):S10–5. https://doi.org/10.1093/cid/cis361
  • 2. Daw MA, Dau AA. Hepatitis C virus in Arab world: a state of concern. Scientific World Journal. 2012;2012:719494. https://doi.org/10.1100/2012/719494
  • 3. Hassan-Kadle MA, Osman MS, Ogurtsov PP. Epidemiology of viral hepatitis in Somalia: Systematic review and meta-analysis study. World J Gastroenterol. 2018 Sep 14;24(34):3927–57. https://doi.org/10.3748/wjg.v24.i34.3927
  • 4. Loggi E, Vukotic R, Conti F, Gitto S, Andreone P. Gold standard assays for the monitoring of patients with chronic hepatitis C. Future Virol. 2018 Aug;13(8):529–37. https://doi.org/10.2217/fvl-2018-0032
  • 5. Misdraji J. Changing indications for liver biopsy: viral hepatitis. Diagnostic Histopathol. 2014 Mar 1;20(3):119–24. https://doi.org/10.1016/j.mpdhp.2014.01.010
  • 6. Giannini E, Risso D, Botta F, Chiarbonello B, Fasoli A, Malfatti F, et al. Validity and Clinical Utility of the Aspartate Aminotransferase–Alanine Aminotransferase Ratio in Assessing Disease Severity and Prognosis in Patients With Hepatitis C Virus–Related Chronic Liver Disease. Arch Intern Med. 2003 Jan 27;163(2):218. https://doi.org/10.1001/archinte.163.2.218
  • 7. Karagoz E, Ulcay A, Tanoglu A, Kara M, Turhan V, Erdem H, et al. Clinical usefulness of mean platelet volume and red blood cell distribution width to platelet ratio for predicting the severity of hepatic fibrosis in chronic hepatitis B virus patients. Eur J Gastroenterol Hepatol. 2014 Sep;26(12):1. https://doi.org/10.1097/MEG.0000000000000203
  • 8. Shao LN, Zhang ST, Wang N, Yu WJ, Chen M, Xiao N, et al. Platelet indices significantly correlate with liver fibrosis in HCV-infected patients. PLoS One. 2020;15(1):1–9. https://doi.org/10.1371/journal.pone.0227544
  • 9. Eminler AT, Ayyildiz T, Irak K, Kiyici M, Gurel S, Dolar E, et al. AST/ALT ratio is not useful in predicting the degree of fibrosis in chronic viral hepatitis patients. Eur J Gastroenterol Hepatol. 2015 Dec;27(12):1361–6. https://doi.org/10.1097/MEG.0000000000000468
  • 10. Guéchot J, Boisson RC, Zarski J-P, Sturm N, Calès P, Lasnier E. AST/ALT ratio is not an index of liver fibrosis in chronic hepatitis C when aminotransferase activities are determinate according to the international recommendations. Clin Res Hepatol Gastroenterol. 2013 Nov;37(5):467–72. https://doi.org/10.1016/j.clinre.2013.07.003
  • 11. Haklar G. Liver function tests in chronic viral hepatitis cases. Marmara Med J. 2016 Oct 10;29(4):6. https://doi.org/10.5472/MMJsi.2901.03
  • 12. Reedy DW, Loo AT, Levine RA. AST/ALT ratio > or = 1 is not diagnostic of cirrhosis in patients with chronic hepatitis C. Dig Dis Sci. 1998 Sep;43(9):2156–9. https://doi.org/10.1023/a:1018888021118
  • 13. Castera L, Vergniol J, Foucher J, Le Bail B, Chanteloup E, Haaser M, et al. Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology. 2005 Feb;128(2):343–50. https://doi.org/10.1053/j.gastro.2004.11.018
  • 14. Canbakan M, Senturk H, Canbakan B, Toptas T, Tabak O, Ozaras R, et al. Validation of Biochemical Markers for the Prediction of Liver Fibrosis and Necroinflammatory Activity in Hemodialysis Patients with Chronic Hepatitis C. Nephron Clin Pract. 2011;117(3):c289–95. https://doi.org/10.1159/000320751
  • 15. Lin Z-H, Xin Y-N, Dong Q-J, Wang Q, Jiang X-J, Zhan S-H, et al. Performance of the aspartate aminotransferase-to-platelet ratio index for the staging of hepatitis C-related fibrosis: An updated meta-analysis. Hepatology. 2011 Mar;53(3):726–36. https://doi.org/10.1002/hep.24105
  • 16. Sterling RK, Lissen E, Clumeck N, Sola R, Correa MC, Montaner J, et al. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology. 2006 Jun;43(6):1317–25. https://doi.org/10.1002/hep.21178
  • 17. Taefi A, Kirthi CH, Suzan K. Red cell distribution width to platelet ratio , a useful indicator of liver fibrosis in chronic hepatitis patients. Hepatol Int. 2015;9(3):454–60. https://doi.org/10.1007/s12072-015-9638-9
  • 18. He Q, He Q, Qin X, Li S, Li T, Xie L, et al. The Relationship between Inflammatory Marker Levels and Hepatitis C Virus Severity. 2016;2016. https://doi.org/10.1155/2016/2978479

Somali Mogadişu Hastanesinde Hepatit C Virüsü Enfeksiyonunun İzlenmesinde Dolaylı Biyobelirteçlerin Değeri

Year 2022, Volume: 6 Issue: 2, 158 - 164, 31.08.2022
https://doi.org/10.29058/mjwbs.1100914

Abstract

Amaç: Somali Mogadişu Hastanesi’ne başvuran Hepatit C virüsü enfeksiyonu [anti-HCV (+)]
olan hastaların laboratuvar testlerinde, karaciğer hastalığının ilerlemesini öngören Sınıf II fibrozis
belirteçlerinin değerini ve trombosit parametrelerindeki değişiklikleri araştırmayı amaçladık.
Gereç ve Yöntemler: Hastanemizde muayene edilen 18 yaş üstü tüm hastalar çalışmaya dahil edildi.
CBC ve hastalardan alınan biyokimyasal ölçüm sonuçları eşliğinde, dolaylı karaciğer fibrozu (Sınıf II)
belirteçleri AAR (AST/ALT oranı), APRI (AST/Plt oran indeksi) ve FIB-4 indeksi (Yaş (yıl) x AST (U/L) )
/ [Platelet sayısı (109 / L)] x (ALT) 1/2 (U / L)], MPV/Platelet oranı, APRI = [(kişi AST/AST referans üst
limiti) x Trombosit (103 /ml) x 100] hesaplandı.
Bulgular: Çalışmamıza medyan yaşı 51 (32-67) yıl olan 1.605 (%55.6) erkek ve 1.282 (%44.4) kadın
olmak üzere toplam 2.887 hasta dahil edildi. Erkeklerde anti-HCV pozitiflik oranı kadınlara göre 1,5 kat
daha yüksek bulundu. Karaciğer hasarının dolaylı belirteçleri olan APRI, MPV / Plt R ve RPR düzeyleri,
anti-HCV (+) olan hastalarda kontrol grubuna göre daha yüksek bulundu (p<0,001). Anti HCV (+) hastaların
medyan FIB-4 değeri 1,94 (0,07-297.41) olarak bulundu. Sonuç: Özellikle APRI, MPR, MPV/Plt oranı ve FIB-4 biyobelirteçlerinin Sahra Altı Afrika bölgesinde anti-HCV (+) olan hastalarda fibrozisi
göstermede ve şiddetini tahmin etmede faydalı testler olduğunu düşünüyoruz.

References

  • 1. Averhoff FM, Glass N, Holtzman D. Global Burden of Hepatitis C: Considerations for Healthcare Providers in the United States. Clin Infect Dis. 2012 Jul 15;55(suppl_1):S10–5. https://doi.org/10.1093/cid/cis361
  • 2. Daw MA, Dau AA. Hepatitis C virus in Arab world: a state of concern. Scientific World Journal. 2012;2012:719494. https://doi.org/10.1100/2012/719494
  • 3. Hassan-Kadle MA, Osman MS, Ogurtsov PP. Epidemiology of viral hepatitis in Somalia: Systematic review and meta-analysis study. World J Gastroenterol. 2018 Sep 14;24(34):3927–57. https://doi.org/10.3748/wjg.v24.i34.3927
  • 4. Loggi E, Vukotic R, Conti F, Gitto S, Andreone P. Gold standard assays for the monitoring of patients with chronic hepatitis C. Future Virol. 2018 Aug;13(8):529–37. https://doi.org/10.2217/fvl-2018-0032
  • 5. Misdraji J. Changing indications for liver biopsy: viral hepatitis. Diagnostic Histopathol. 2014 Mar 1;20(3):119–24. https://doi.org/10.1016/j.mpdhp.2014.01.010
  • 6. Giannini E, Risso D, Botta F, Chiarbonello B, Fasoli A, Malfatti F, et al. Validity and Clinical Utility of the Aspartate Aminotransferase–Alanine Aminotransferase Ratio in Assessing Disease Severity and Prognosis in Patients With Hepatitis C Virus–Related Chronic Liver Disease. Arch Intern Med. 2003 Jan 27;163(2):218. https://doi.org/10.1001/archinte.163.2.218
  • 7. Karagoz E, Ulcay A, Tanoglu A, Kara M, Turhan V, Erdem H, et al. Clinical usefulness of mean platelet volume and red blood cell distribution width to platelet ratio for predicting the severity of hepatic fibrosis in chronic hepatitis B virus patients. Eur J Gastroenterol Hepatol. 2014 Sep;26(12):1. https://doi.org/10.1097/MEG.0000000000000203
  • 8. Shao LN, Zhang ST, Wang N, Yu WJ, Chen M, Xiao N, et al. Platelet indices significantly correlate with liver fibrosis in HCV-infected patients. PLoS One. 2020;15(1):1–9. https://doi.org/10.1371/journal.pone.0227544
  • 9. Eminler AT, Ayyildiz T, Irak K, Kiyici M, Gurel S, Dolar E, et al. AST/ALT ratio is not useful in predicting the degree of fibrosis in chronic viral hepatitis patients. Eur J Gastroenterol Hepatol. 2015 Dec;27(12):1361–6. https://doi.org/10.1097/MEG.0000000000000468
  • 10. Guéchot J, Boisson RC, Zarski J-P, Sturm N, Calès P, Lasnier E. AST/ALT ratio is not an index of liver fibrosis in chronic hepatitis C when aminotransferase activities are determinate according to the international recommendations. Clin Res Hepatol Gastroenterol. 2013 Nov;37(5):467–72. https://doi.org/10.1016/j.clinre.2013.07.003
  • 11. Haklar G. Liver function tests in chronic viral hepatitis cases. Marmara Med J. 2016 Oct 10;29(4):6. https://doi.org/10.5472/MMJsi.2901.03
  • 12. Reedy DW, Loo AT, Levine RA. AST/ALT ratio > or = 1 is not diagnostic of cirrhosis in patients with chronic hepatitis C. Dig Dis Sci. 1998 Sep;43(9):2156–9. https://doi.org/10.1023/a:1018888021118
  • 13. Castera L, Vergniol J, Foucher J, Le Bail B, Chanteloup E, Haaser M, et al. Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology. 2005 Feb;128(2):343–50. https://doi.org/10.1053/j.gastro.2004.11.018
  • 14. Canbakan M, Senturk H, Canbakan B, Toptas T, Tabak O, Ozaras R, et al. Validation of Biochemical Markers for the Prediction of Liver Fibrosis and Necroinflammatory Activity in Hemodialysis Patients with Chronic Hepatitis C. Nephron Clin Pract. 2011;117(3):c289–95. https://doi.org/10.1159/000320751
  • 15. Lin Z-H, Xin Y-N, Dong Q-J, Wang Q, Jiang X-J, Zhan S-H, et al. Performance of the aspartate aminotransferase-to-platelet ratio index for the staging of hepatitis C-related fibrosis: An updated meta-analysis. Hepatology. 2011 Mar;53(3):726–36. https://doi.org/10.1002/hep.24105
  • 16. Sterling RK, Lissen E, Clumeck N, Sola R, Correa MC, Montaner J, et al. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology. 2006 Jun;43(6):1317–25. https://doi.org/10.1002/hep.21178
  • 17. Taefi A, Kirthi CH, Suzan K. Red cell distribution width to platelet ratio , a useful indicator of liver fibrosis in chronic hepatitis patients. Hepatol Int. 2015;9(3):454–60. https://doi.org/10.1007/s12072-015-9638-9
  • 18. He Q, He Q, Qin X, Li S, Li T, Xie L, et al. The Relationship between Inflammatory Marker Levels and Hepatitis C Virus Severity. 2016;2016. https://doi.org/10.1155/2016/2978479
There are 18 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Article
Authors

Öznur Sarı 0000-0003-2234-8190

Publication Date August 31, 2022
Acceptance Date July 18, 2022
Published in Issue Year 2022 Volume: 6 Issue: 2

Cite

Vancouver Sarı Ö. The Value of Indirect Biomarkers in the Monitoring of Hepatitis C Virus Infection at the Mogadishu Hospital, Somalia. Med J West Black Sea. 2022;6(2):158-64.

Medical Journal of Western Black Sea is a scientific publication of Zonguldak Bulent Ecevit University Faculty of Medicine.

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