Hepa-index, a New Biomarker Indicator of Hepatic Fibrosis in Patients with Chronic Liver Disease

Abstract

• AIM: Noninvasive methods for assessment and follow-up of hepatic fibrosis are important for the management of patients with chronic liver disease. Our aim was to assess a new panel of surrogate biomarkers for prediction of severe hepatic fibrosis in patients with chronic liver disease of different aetiology.
• METHODS: 118 patients (62 males (52.5%) and 56 females (47.5%) were prospectively enrolled with a mean age of 55.6 years ± 14.9. The aetiology of chronic liver disease was hepatitis B virus infection (n=12), hepatitis C virus infection (n=20), autoimmune hepatitis (n=36), alcoholic steatohepatitis (n=10), non-alcoholic steatohepatitis: (n=12), hepatocellular carcinoma (n=16). 12 patients had no evidence of liver disease. Biomarkers of hepatic fibrosis and liver function tests (α2-macroglobulin, haptoglobin, apolipoprotein A1, total bilirubin, GGT, ALT, total cholesterol, AST, albumin, CA19-9, CA125, CA 15-3, INR, platelet count, hyaluronic acid, nitric oxide) were analyzed in serum. As reference for staging of fibrosis we used FibroTest and FibroScan. Biomarkers were correlated to hepatic fibrosis by univariate and multivariate analyses as well as logistic regression.
• RESULTS: Univariate and multivariate analysis indicated that platelet count, α2-macroglobulin, total bilirubin, GGT and total cholesterol were the most relevant biomarkers related to the stage of hepatic fibrosis. A new panel for prediction of severe hepatic fibrosis was created using these relevant parameters. Applying this panel; severe hepatic fibrosis was predicted with a sensitivity of 97.4% and a specificity of 85.9% in comparison with FibroTest. Also a sensitivity of 78.8% and specificity of 90.9% was obtained by the panel in comparison to FibroScan.
• CONCLUSION:The new noninvasive panel allows accurate prediction of severe liver fibrosis in different types of chronic liver disease.