Biochemical markers in blood can predict the cirrhotic evolution of chronic hepatitis

ABSTRACT

Approximately one-fifth of chronically infected patients develop significant chronic liver inflammation that progressively can lead to cirrhosis and HCC. The course and outcome of chronic liver disease may be difficult to predict. There is an urgent need to develop and validate noninvasive tests that can accurately reflect the full spectrum of hepatic inflammation and fibrosis. Serum fibronectin can differentiate HCV infected patients with liver fibrosis from patients with non fibrosis. Serum pseudocholinesterase activity might be a more specific indicator of liver dysfunction than the traditional liver function tests while prothrombin time is a measurement of synthetic liver function. To study the ability of three serum biochemical markers when combined in specific equation can differentiate between chronic active hepatitis and cirrhotic patients. Patients were 29 with chronic active hepatitis [CAR] and 28 with liver cirrhosis. These were compared with 10 healthy controls. Liver function tests were done to all subjects. Three biochemical parameters were also measured and combined in a certain equation. Fibronectin was measured using ELISA, pseudocholinesterase using colorimetric method while prothrombin activity was done using calcium thromboplastin. It was found that the equation significantly discriminated between fibrosis and cirrhosis at cut off value of 243.28, with sensitivity 100% and specificity 60% and area under the curve 80%, p=0.000. The three biochemical inexpensive parameters when combined can contribute to the differentiation between liver cirrhosis and chronic hepatitis