title: Evaluation of serum biomarkers of fibrosis and injury in Egyptian patients with chronic hepatitis C.
abstract: OBJECTIVE
  We evaluated whether surrogate serum biomarkers for liver injury are comparable to liver biopsy in Egyptian patients with hepatitis C virus (HCV) infection.
  
  
  METHODS
  Two hundred and twenty Egyptian patients, 91% infected with genotype-4 HCV, undergoing liver biopsy during evaluation for interferon/ribavirin therapy.
  
  
  METHODS
  Liver biopsy scored by the Ishak method was compared to biochemical tests, platelet count and two fibrosis biomarkers: hyaluronic acid (HA) and YKL-40. Univariate and logistic regression analyses determined independent predictors of fibrotic, inflammatory, and fatty changes. Biomarkers were evaluated for ability to differentiate between severe fibrosis/cirrhosis and no/mild fibrosis.
  
  
  RESULTS
  Although increasing age, HA, YKL-40, AST, reduced platelet count, and AST and HA/platelet count ratios were associated with fibrosis by univariate analysis, the other variables were not significant after controlling for HA (p=0.0001) and age (p=0.004). Although age and some biomarkers were associated with inflammation, none remained significant after controlling for fibrosis. YKL-40 (p=0.04) and aspartate aminotransferase (p=0.05) remained associated with steatosis after controlling for fibrosis.
  
  
  CONCLUSIONS
  In Egyptians with chronic HCV, young patients with low levels of HA are at very low risk of fibrosis. This can limit the number of liver biopsies to those whose clinical findings conflict with the biomarker results.
authors.affiliation: National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.
authors.forename: Gamal
authors.initials: G
authors.lastname: Esmat
authors.forename: Mohamed
authors.initials: M
authors.lastname: Metwally
authors.forename: Khalid R
authors.initials: KR
authors.lastname: Zalata
authors.forename: Shahinaz
authors.initials: S
authors.lastname: Gadalla
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdel-Hamid
authors.forename: Amr
authors.initials: A
authors.lastname: Abouzied
authors.forename: Abdel-Aziz
authors.initials: AA
authors.lastname: Shaheen
authors.forename: Maissa
authors.initials: M
authors.lastname: El-Raziky
authors.forename: Hani
authors.initials: H
authors.lastname: Khatab
authors.forename: Sherif
authors.initials: S
authors.lastname: El-Kafrawy
authors.forename: Nabiel
authors.initials: N
authors.lastname: Mikhail
authors.forename: Laurence S
authors.initials: LS
authors.lastname: Magder
authors.forename: Nezam H
authors.initials: NH
authors.lastname: Afdhal
authors.forename: G Thomas
authors.initials: GT
authors.lastname: Strickland
mesh_terms: D054392:Adipokines; D000328:Adult; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D000071451:Chitinase-3-Like Protein 1; D003430:Cross-Sectional Studies; D004534:Egypt; D005234:Fatty Liver / Q000097:blood / Q000821:virology; D005260:Female; D006023:Glycoproteins / Q000097:blood; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D037102:Lectins; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000097:blood* / Q000473:pathology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009656:North America; D010976:Platelet Count
chemical_list: D054392:Adipokines; D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D006023:Glycoproteins; D037102:Lectins; D006820:Hyaluronic Acid; D001219:Aspartate Aminotransferases