The role of neopterin detecting disease severity in patients withHBV related chronic liver disease

Objective: Neopterin is a derivative of pteridine formed as a result of activation of the innate immune system. It is used as a biomarker in diseases where immune mechanisms are activated. Hepatitis B is a virus that causes inflammation of the liver. Although neopterin showed the presence of inflammatory activity, it was aimed to examine the change in the severity of the disease with the data obtained from individuals with chronic liver disease with Hepatitis B. Materials and Methods: Volunteer individuals with chronic liver disease with Hepatitis B, who applied to the Hepatology Outpatient Clinic at İnönü University Turgut Özal Medical Center between 2021-2023, who were hospitalized in the Hepatology in patient ward and applied to the Liver Transplantation Outpatient Clinic, were included in the study. The control group includes volunteer individuals consisting of health workers between the ages of 18-65 at İnönü University Turgut Özal Medical Center. In serum samples, Neopterin, IFN-γ and TNF-α levels were investigated using the ELISA kit method. The results were correlated according to the disease scoring system, the distribution of MELD scores and EF-CLIF ACLF. Results: No statistically significant relationship was found between serum neopterin levels, age, gender, and level of liver function tests in 78 patients included in the study. Statistical significance was found between serum neopterin, IFN- γ, TNF-a, mortality of the disease, HBeAg, HBsAg, INR, platelet levels and MELD (p=0.002). Conclusions and Recommendations: In hepatitis B infection, the IFN gamma released from cytotoxic T cells activates the macrophages in the liver, stimulating the release of neopterin from these macrophages. INF-γ stimulates the production and release of neopter from human macrophages. T cell and macrophage activation is also the root cause of necroinflammation and fibrosis in the liver. Neopterin levels are thought to reflect the degree of Hepatitis B infection in the liver. The statistically significant relationship between the serum neopter level and the MELD score. Neopterin is a biomarker for severity of the liver damage encountered in Hepatitis B related liver disease. Keywords: Hepatitis B, Liver Diseases, Neopterin