Ceruloplasmin, a reliable marker of fibrosis in chronic hepatitis B virus patients with normal or minimally raised alanine aminotransferase

نویسندگان

  • Da-Wu Zeng
  • Jing Dong
  • Jia-Ji Jiang
  • Yue-Yong Zhu
  • Yu-Rui Liu
چکیده

AIM To develop a non-invasive model to evaluate significant fibrosis and cirrhosis by investigating the association between serum ceruloplasmin (CP) levels and liver fibrosis in chronic hepatitis B (CHB) patients with normal or minimally raised alanine aminotransferase (ALT). METHODS Serum samples and liver biopsy were obtained from 193 CHB patients with minimally raised or normal ALT who were randomly divided into a training group (n = 97) and a validation group (n = 96). Liver histology was evaluated by the METAVIR scoring system. Receiver operator characteristic curves were applied to the diagnostic value of CP for measuring liver fibrosis in CHB patients. Spearman rank correlation analyzed the relationship between CP and liver fibrosis. A non-invasive model was set up through multivariate logistic regression analysis. RESULTS Serum CP levels individualized various fibrosis stages via area under the curve (AUC) values. Multivariate analysis revealed that CP levels were significantly related to liver cirrhosis. Combining CP with serum GGT levels, a CG model was set up to predict significant fibrosis and liver cirrhosis in CHB patients with normal or minimally raised ALT. The AUC, sensitivity, specificity, positive predictive value, and negative predictive value were 0.84, 83.1%, 78.6%, 39.6%, and 96.5% to predict liver cirrhosis, and 0.789, 80.26%, 68.38%, 62.25%, and 84.21% to predict significant fibrosis. This model expressed a higher AUC than FIB-4 (age, ALT, aspartate aminotransferase, platelets) and GP (globulin, platelets) models to predict significant fibrosis (P = 0.019 and 0.022 respectively) and revealed a dramatically greater AUC than FIB-4 (P = 0.033) to predict liver cirrhosis. CONCLUSION The present study showed that CP was independently and negatively associated with liver fibrosis. Furthermore, we developed a novel promising model (CG), based on routine serum markers, for predicting liver fibrosis in CHB patients with normal or minimally raised ALT.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

A Mechanistic Assessment of the Discordance between Normal Serum Alanine Aminotransferase Levels and Altered Liver Histology in Chronic Hepatitis B

To understand the mechanisms underlying the discordance between normal serum alanine aminotransferase (ALT) levels and significant alterations in liver histology of chronic hepatitis B virus (HBV) infection with persistent normal ALT (PNALT) or minimally elevated ALT. A total of 300 treatment-naive chronic HBV-infected patients with PNALT (ALT ≤ upper limit of normal [ULN, 40 U/ml]) or minimall...

متن کامل

Significance of Hepatitis B Core Antibody as the Only Marker of Hepatitis B Virus Infection in High Risk Patients

  Background and Objective: Presence of hepatitis B core antibody (anti-HBc) in the absence of hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (anti-HBs) is defined, as isolated anti-HBc. little is known about the clinical significance of the isolated anti-HBc in hepatitis B virus (HBV) infections. The aim of this study was to assess the significance of anti-HBc as the onl...

متن کامل

Evaluation of the need for treatment on 72 subjects with anti-HBe positive chronic hepatitis B

Background: Viral load and alanine aminotransferase (ALT) levels may not be the key points for making a decision in the treatment of anti-HBe positive chronic hepatitis B. The purpose of this study was to assess the histological evaluation of liver to find the need for treatment on 72 patients with anti-HBe positive chronic hepatitis B. Methods: The liver biopsy slides of the 72 patients (56 s...

متن کامل

Is Quantitative HBsAg Measurement a Reliable Substitute for HBV DNA Quantitation?

Background: Hepatitis B surface antigen (HBsAg) is one of the main proteins of HBV envelop and its serum quantitative measurement is the most common quantitative test for monitoring the progress of Chronic Hepatitis B. Although measurement of serum HBV DNA copy number is a gold standard method for displaying viral load, the test is relatively expensive and it is not readily available everywhere...

متن کامل

Modulation of liver enzymes by an Iranian preparation of Echinacea purpurea

Hepatitis B, a common infectious disease of liver, is transmitted by blood and body fluids like semen and vaginal fluid that carry hepatitis B virus (HBV).  In chronic infection, medical care is required to decrease possibility of cirrhosis and liver cancer. In the present report, the hepatoprotective effect of an Echinacea purpurea preparation (Echiherb®) has been described...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره 22  شماره 

صفحات  -

تاریخ انتشار 2016