Diagnostic value of serum hyaluronic acid, matrix metalloproteinase-2, tissue inhibitor of matrix metalloproteinase-1 and aminoterminal pebtide of pro-collagen III in patients with chronic hepatitis B

Liver fibrosis, results from excessive accumulation of extracellular matrix. Assesment of fibrosis is critical to determine antiviral therapy, prognosis and the potential risks for complications in patients with chronic viral hepatitis. Liver biopsy is recommended in the majority of patients with chronic viral hepatitis for fibrosis evaluation. Because of the disadvantages and invasiveness of liver biopsy, many studies related to noninvasive biomarkers and scores have been performed. In this study, we aimed to assess the diagnostic value of HA, MMP-2, TIMP-1, PIIINP and noninvasive fibrosis models to predict liver fibrosis in the treatment-naive CHB patients and to compare their diagnostic performance.This study included 58 patients with a diagnosis of chronic HBV infection and 30 healthy controls. HA, MMP-2, TIMP-1 and PIIINP were measured by ELİSA; and the OELF, ELF panel, PP score, APRI, FIB-4 indexes were calculated using the formulas taken from previous publications. Fibrosis stage was determined using Ishak?s scoring system.Among all the markers analyzed the mean values of APRI, FIB-4, OELF, ELF were significantly higher in CHB patients than in healthy controls. The diagnostic value of all the noninvasive indeces was low to detect mild fibrosis. The diagnostic accuracy of predicting ? F3 fibrosis by using HA, OELF, ELF, APRI, PP score and PIIINP were very good with an AUROC of 0.932, 0.833, 0.830, 0.823, 0.831, 0.807, respectively. We demonstrated that hyaluronic acid has highest AUROC for predicting ? F3 fibrosis, and PP score, OELF and ELF were superior to other fibrosis prediction models. In our study the results from a combination of tests showed that ELF &APRI had the highest diagnostic value for detection of moderate to severe fibrosis.In conclusion, a combination of tests has a beter diagnostic value in predicting moderate to severe fibrosis. Further studies with higher number of patients are needed to validate the usefulness of these markers and their combinations.