Diagnostic value of RDW, NLR, MPV tests in predicting liver histopathology in patients with chronic hepatitis b; a retrospective study

Hepatitis B Virus (HBV) is an enveloped DNA virus that can infect humans. When the surface antigen of the virus (HBsAg) remains positive in serum for 6 months or longer, it is called chronic hepatitis B infection (CHB). Liver biopsy is the gold standard method in the clinical follow-up of CHB, especially in determining the indication for antiviral treatment. Since liver biopsy is an invasive procedure and can cause serious morbidity and mortality, the search for new methods continues. Our study aimed to investigate the value of MPV, NLR and RDW parameters measured in routine complete blood count test in predicting the liver biopsy result while determining the indication for antiviral treatment in the clinical follow-up of CHB patients. As a secondary outcome, the value of the same parameters in the treatment follow-up was investigated at the 6th months of patients who started treatment. 102 patients diagnosed with CHB who applied to our hospital between 01.01.2010 and 01.01.2023 and met the study criteria were included in the study. According to the liver biopsy evaluations, there were 66 patients in the treatment group and 36 patients in the control group. The mean age of the whole sample was 42,9 years. 62,1% of the treatment group and 55,6% of the control group were male. Treatment and control groups were similar with regard to gender and age variables (p>0,05). There was no difference between the treatment and control groups with regard to MPV, NLR and RDW parameters (p>0,05). In the 6-month follow-up of the treatment group, MPV value decreased (p=0,019), NLR value did not change (p>0,05) and RDW value increased (p=0,006). Additionally, AST, ALT, FIB4 parameters were higher in the treatment group than in the control group, and these parameters were lower after treatment than before treatment (p<0,05). In addition, these parameters were correlated with fibrosis and necroinflammation scores determined in pathology (p<0,05). It was concluded that MPV, NLR and RDW parameters measured with a complete blood count test cannot replace liver biopsy in predicting the indication for antiviral treatment in patients with CHB. Among these parameters, MPV was thought to be promising in the follow-up of antiviral treatment response. AST, ALT and FIB4 parameters were forecasted to be useful both in determining the indication for treatment and in the follow-up of treatment response.