title: The relationship between fibrosis level and blood neutrophil to lymphocyte ratio in inactive hepatitis B carriers.
abstract: OBJECTIVE
  Neutrophil-lymphocyte ratio (NLR) has been used as a simple, affordable, and easily accessible marker to predict prognosis in a variety of inflammatory and neoplastic diseases. However, there are few studies investigating their role in patients with hepatitis B. The aim of this study was to investigate the relationship between NLR and liver fibrosis in patients who were being followed as inactive hepatitis B carriers.
  
  
  METHODS
  The study included 78 patients who were followed for 1 year as inactive hepatitis B carriers. Liver biopsy was performed and the fibrosis scores of the histological activity index were assessed according to the Metavir scoring system. The patients were divided into two groups on the basis of the fibrosis scores: those with a score below 2 and those with a score above 2. In both groups, demographic data such as sex, age, and BMI were similar. The NLR of patients was calculated from blood samples taken at the same time as the biopsy.
  
  
  RESULTS
  Histopathologic analysis of 78 patients showed that 41 (53%) had fibrosis grade 0-1 and 37 (47%) patients had fibrosis grade greater than 2. According to the biopsy results, there were no cirrhotic patients. NLR was found to be statistically significantly lower in the group with fibrosis grade of at least 2 (1.51±0.61 vs. 1.79±0.64, P=0.043). Other biochemical and hematological data were found to be similar in both groups. No correlation was found between laboratory values and NLR. In addition, there was no correlation between NLR with histologic activity. Spearman correlation analysis showed a negative correlation between the fibrosis score and NLR (r=-0.279, P=0.013).
  
  
  CONCLUSIONS
  In inactive hepatitis B carriers, the histological activity index and NLR were found to be correlated negatively. NLR can be used as a predictor of fibrosis in combination with other noninvasive markers.
authors.affiliation: aDepartment of Gastroenterology, Izzet Baysal State Hospital bDepartment of Gastroenterology, Abant Izzet Baysal University School of Medicine, Bolu Departments of cInternal Medicine dGastroenterology, Kocaeli University School of Medicine, Kocaeli, Turkey eCleveland Clinic, Department of Pathobiology, Cleveland, Ohio, USA.
authors.forename: Bülent
authors.initials: B
authors.lastname: Yilmaz
authors.forename: Hayrunnisa
authors.initials: H
authors.lastname: Aydin
authors.forename: Güray
authors.initials: G
authors.lastname: Can
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Şentürk
authors.forename: Berna
authors.initials: B
authors.lastname: Üstüner
authors.forename: Hasan
authors.initials: H
authors.lastname: Yilmaz
authors.forename: Murat
authors.initials: M
authors.lastname: Öztürkler
authors.forename: Emir C
authors.initials: EC
authors.lastname: Roach
authors.forename: Uğur
authors.initials: U
authors.lastname: Korkmaz
authors.forename: Mevlüt
authors.initials: M
authors.lastname: Kurt
authors.forename: Altay
authors.initials: A
authors.lastname: Çelebi
authors.forename: Ömer
authors.initials: Ö
authors.lastname: Şentürk
authors.forename: Sadettin
authors.initials: S
authors.lastname: Hülagü
mesh_terms: D000328:Adult; D001706:Biopsy; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D013997:Time Factors