Analysis of Biomarkers in Patients Infected with Hepatitis B Virus

APRI, FIB-4, and PCT scoring systems in predicting liver inflammation and fibrosis in CHB patients. The study examined 602 patients with a pre-diagnosis of CHB, aged 18 and older, who had been HBsAg positive for at least six months, and who applied to the Süleyman Demirel University Faculty of Medicine Infectious Diseases and Clinical Microbiology Clinic between 01.01.2012 and 01.01.2024. Based on biopsy results, 175 patients who complying with the Health Practice Communique (HPC) treatment criteria and were compatible with chronic hepatitis, 126 patients who did not meet the HPC treatment criteria and were compatible with chronic infection, and 301 patients who were followed up with a diagnosis of chronic infection without a biopsy, were divided into three groups. The PIV, SII, APRI, FIB-4 and PCT scores were compared among the groups. In the group compatible with chronic hepatitis based on biopsy, PIV scoring was found to be lower compared to the chronic infection group (biopsied and non-biopsied). Furthermore, when the biopsy group was divided into two groups based on low and high fibrosis, the PIV score was found to be lower in the high fibrosis group. In those diagnosed with chronic hepatitis according to biopsy results, FIB-4 and APRI scores were higher, while SII and PCT values were lower. Considering the current reimbursement criteria that include FIB-4, APRI and ALT values, it was found that 65,1% of patients followed up with a chronic hepatitis diagnosis did not meet these criteria, despite having biopsy results compatible with chronic hepatitis. Furthermore, it was observed that 15,9% of patients in the group who did not start treatment and whose biopsy results were consistent with chronic infection, could receive treatment according to the newly added conditions in the HPC. In our study, it is thought that the lower PIV, SII, and PCT values in the group with high liver fibrosis and inflammation might be due to a decrease in platelet levels. While the FIB-4 and APRI scores are successful in predicting liver inflammation and fibrosis, it should be noted that there is still a need for biopsy. Keywords: Biomarkers, liver fibrosis, chronic hepatitis B, pan-immun inflammation value, platelet