The effect of helicobacter pylori presence on assessment of hepati̇c fi̇brosi̇s using aspartate aminotransferase to platelet ratio and fibrosis-4 index

Objective: Early detection, accurate evaluation and follow-up of fibrosis in chronic liver diseases affect the prognosis of the disease positively. Although biopsy is the gold standard method for determining fibrosis, this method is not practical. Therefore, indirect biochemical fibrosis tests have been developed to determine fibrosis. These tests are performed using various factors such as AST, ALT and platelet count, which have been shown to affect H. pylori as well. Therefore, the effect of H. pylori on indirect biochemical fibrosis tests should be clarified. In our study, we aimed to determine the effect of the presence of H. pylori on APRI and FIB-4 scores, which are indirect fibrosis tests used to evaluate liver fibrosis. Material and Method: The study included 190 patients over the age of 18 who had gastric and liver biopsy between January 2006 and January 2021, followed by Dokuz Eylul University Hospital Gastroenterology Department Polyclinics. Patients were divided into three groups as mild (F0-1), moderate (F2-3) and advanced (F4-6) fibrosis according to liver histopathological examination results. In addition, according to the histopathological examination of the stomach, it was divided into two groups in terms of the presence and absence of H. pylori. Demographic, clinical, laboratory, imaging and histopathological characteristics of the patients were examined and the groups were compared. Results: Of the 190 patients included in the study; 100 (52.6%) were female and 90 (47.4%) were male. The mean age of the patients was 53.39 ± 12.68 years, and the median age was 55 years. H. pylori was detected in 135 (71%) patients, and H. pylori was not detected in 55 (29%) patients. There was no significant difference between the H. pylori detected and undetected groups in terms of AST, ALT, platelet count, INR, FIB-4, APRI. When these three groups are evaluated in terms of APRI; There was a significant difference between mild-moderate and advanced fibrosis groups (p<0.001). However, there was no significant difference between moderate and advanced fibrosis groups (p>0.05). When evaluated in terms of FIB-4; there is a significant difference between mild, moderate and advanced fibrosis groups (p<0.001). These three groups were analyzed separately for the effect of H. pylori on APRI and FIB-4 scores, and no significant difference was found. Conclusion: There was no statistically significant effect of the presence of H. pylori on FIB-4 and APRI. Unrelated to H. pylori, FIB-4 and APRI scores can be used safely in the evaluation of liver fibrosis. Keywords: Helicobacter pylori, liver fibrosis, APRI, FIB-4