CIRCULATING APOLIPOPROTEIN A1, HAPTOGLOBIN AND Α2 MACROGLOBULIN AS FIBROSIS MARKERS IN CHRONIC HEPATITIS C PATIENTS

Introduction: Hepatitis C virus (HCV) infection is one of the commonest chronic liver diseases worldwide. Progression to chronic disease occurs in the majority of HCV infected patients. Aim: The aim of the present work was to study serum levels of α2 macroglobulin (α2-MG), Apolipoprotein A1 (Apo-1) and Haptoglobin (HP) as non-invasive index of the presence of cirrhosis in chronic hepatitis C patients in relation to the histopathological findings. Subjects and Methods: The study was carried out on 20 patients with chronic HCV and liver cirrhosis (Group I), 20 patients with chronic HCV without liver cirrhosis (Group II) and 10 healthy subjects of mathing age and sex as controls (Group III). Quantitative estimation of α2- MG, HP and Apo AI in serum was done using turbidimetry. Results: The mean serum level of α2- MG was significantly higher in group I than in groups II, III (F=12.8) (p=0.00). On the other hand, Serum Apo A1 and HP were significantly lower in group I than in groups II, III (F=5.9 and 26.3) (p=0.005 and 0.00). On the other hand, no significant difference was found between groups II and III. Significant positive correlation was observed between serum α2- macroglobulin and Child Pugh score, Grading and staging of liver pathology (P 0.05). On the other hand, significant negative correlation was noticed between serum Apo-1, HP and Child Pugh score, histopathological grading and staging (P 0.05). Conclusion: Elevated serum levels of α2 macroglobulin in addition to low levels of apolipoprotein A1 and haptoglobin might be considered as valuable non invasive parameters for predicting the occurrence of cirrhosis in chronic hepatitis C patients.