Prediction of liver histological lesions with biochemical markers in chronic hepatitis B patients in Iran

Aim: In the current study, we aimed at identifying independent laboratory parameter to predict liver damage. Background: Although liver biopsy is frequently recommended in assessing disease severity and selecting antiviral treatment candidates, it has several limitations. Patients and methods: A total of 527 patients with untreated chronic hepatitis B virus infection were selected. A percutaneous liver biopsy was obtained. All of the patients were graded and staged for liver fibrosis (1-6) and inflammatory activity (1-18). Complete blood count, biochemical blood tests and Serum viral markers were detected for these patients. Results: 106 patients had moderate to severe necroinflammatory activity. Compared to patients with mild activity, this group was older and had significantly higher aspartate aminotransferase (AST), alanine aminotrasferase (ALT), alkalinephosphatase (Alk. P) and AST to platelet ratio index (APRI) and significantly lowers hemoglobin (Hb), fasting blood sugar (FBS) and platelet (PLT). By multiple regressions analysis Hb, AST, FBS and PLT were independently predictive of moderate to severe necroinflammatory activity. 109 patients had moderate to severe fibrosis. Compared to patients with mild fibrosis, the former patients were older. In addition, the mean of AST, ALT, PT and APRI were significantly higher, and WBC, serum Alb and PLT were significantly lower in patients with moderate to severe fibrosis. Also by multiple regressions analysis age, AST, serum Alb and PLT were independently predictive of moderate to severe fibrosis. Conclusion: Our study demonstrates the utility of biochemical markers for the diagnosis of moderate histological lesions in patients with chronic hepatitis B. Whereas millions of patients with chronic hepatitis B in the world are living, this approach will be useful and cost-benefit.