Novel Prognostic Indicators to reflect the grade of liver fibrosis in hepatic patients

Background: Liver fibrosis is the result of a sustained wound healing response to chronic liver injury. The main reasons include chronic hepatitis C virus (HCV), hepatitis B virus (HBV) infection, and Non-alcoholic fatty liver disease (NAFLD). Non-invasive methods of assessing fibrosis are often used in clinical practice as a safer, more accessible, and less costly way than liver biopsy to stratify individuals by risk. The current study early diagnosis of liver fibrosis in patients with hepatitis B, C, and NAFLD using indirect non-invasive biomarkers and evaluating the diagnostic impact of the Study applied on 250 patients divided into five equal groups: HBV Group, HCV Group, HBV + HCV Group, NAFLD Group and Control Group, for each with the same inclusion and exclusion criteria in order to monitor the prevalence of Apolipoprotein B (ApoB) (g/L), Lipoprotein A (mg/dL), Serum Amyloid A (SAA) (mg/L) and Insulin-like growth factor 1 (IGF1) (ng/ml) as biomarkers reflecting the grade of liver fibrosis in hepatic patients. Results: In the terms of Alanine aminotransferase ALT (p < 0.05), Gamma-glutamyltransferase GGT (p < 0.001), Glycosylated hemoglobin HbA1C (p < 0.001), and Apo B(p < 0.001), in the NAFLD group, had the highest value. Meanwhile, the terms of Aspartate aminotransferase AST (p < 0.001), Aspartate aminotransferase to platelet ratio index APRI (p < 0.001), total bilirubin (p < 0.05), and Serum Amyloid A SAA (p < 0.001)in the HCV group had the greatest value. In addition, the HBV+HCV group had the highest AST/ALT value (p < 0.001), α2 macroglobulin (p < 0.001) values. platelets (p < 0.001), haptoglobin (p < 0.001), lipoprotein A (p < 0.001), and Insulin-like growth factor 1 IGF1(p < 0.001) were all greatest in the control group. The biomarkers Lipoprotein (A) in HBV and NAFLD; Apolipoprotein B (ApoB) in HCV and HBV+ HCV group were found to be predictive of early fibrosis using Receiver Operator Characteristics (ROC) curves. Conclusion: The estimation of non-invasive biomarkers (ApoB), (IGF1), (SAA), and Lipoprotein A were the most predictive of early fibrosis in hepatic patients with significant accuracy. These biomarkers can be used as liver biopsy alternatives to support the early diagnosis of liver fibrosis.