Liver fibrosis due to HCV infection is a dynamic process during which different biochemical markers are released in the blood. The aim of this study was to assess non invasive markers of liver fibrosis in CHC and to correlate them with fibrosis stage assessed by liver biopsy. Fourty six cases were subjected to estimation of tissue inhibitor of metalloproteinase 1(TIMP-1) and hyaluronic acid (HA) by ELISA technique, scoring of the age-platelet index(API), AST to platelet ratio index(APRI), and liver biopsy with histopathological grading and staging using METAVIR scoring system. Results: There were positive correlation between age, platelet decrement with fibrosis stage. HA level increased significantly with fibrosis progression, and at cut-off 26.4 ng/ml, can be used to discriminate F>2, as detected by ROC curve, with 80% sensitivity, and 71% specificity. TIMP-1 levels were positively correlated with METAVIR stages, and can be used as a test for F>2 discrimination with 86.7% sensitivity and 64.5% specificity. API showed a significant positive correlation with fibrosis and necroinflammation (P < 0.01), by using ROC curve for F> 2 discrimination with specificity 61.3% and sensitivity 73.3%, when API > 2.5. While APRI showed a significant positive correlation with METAVIR activity grade and stage (p < 0.01), and by using APRI for predicton of significant fibrosis and cirrhosis F > 2, the AUC 0.89 with 93.3% and 74.2% for sensitivity and specificity respectively. Conclusion: HA level had strong positive correlation with significant fibrosis; TIMP-1 levels were positively correlated with METAVIR stage. API and APRI showed significant strong positive correlation with METAVIR stage and activity grade. |
