RESUMO
Background and study aims: Apoptosis represents a well-known mechanism of cell death involved in most chronic liver injuries. Our aim was to investigate the serum fragment level of cytokeratin 18 [CK18], M30, in asymptomatic hepatitis B virus [HBV] carriers and patients with chronic hepatitis B [CHB] and to evaluate the relationship between serum M30 levels and the severity of hepatic injury
Patients and methods: Asymptomatic HBV carriers [n = 169], patients with CHB [n = 100], and healthy control subjects [n = 43] were enrolled in the study. Serum CK18 [M30] levels were analysed in all subjects. Liver biopsy for histopathological assessment was performed in asymptomatic HBV carriers and in patients with CHB infection
Results: Serum CK18 [M30] levels were significantly higher in asymptomatic HBV carriers [198.77 +/- 77.62 U/L] than in healthy control subjects [146.92 +/- 40.18 U/L]. Patients with CHB [283.02 +/- 147.45 U/L] had significantly higher CK18 [M30] levels than asymptomatic HBV carriers [p = 0.001]. The diagnostic efficacy of CK18 [M30] levels in distinguishing patients with HBeAg-negative CHB from asymptomatic HBV carriers was found to be moderate [c-statistics: 0.695], and the diagnostic cut-off value of CK18 [M30] was 262 U/L [specificity: 85%, sensitivity: 48%, positive likelihood ratio: 3.35, and negative likelihood ratio: 0.60]. There was a positive correlation between serum CK18 [M30] levels and histological activity index scores in asymptomatic HBV carriers and patients with CHB
Conclusions: Serum CK18 [M30] levels may be a valuable indicator in distinguishing asymptomatic HBV carriers from patients with HBeAg-negative CHB when considered together with ALT and HBV-DNA levels