Correlation of serum neopterin levels and liver necroinflammation in chronic hepatitis B patients

Aim: Neopterine is a cytokine that is secreted in response to gamma interferon stimulation of human macrophages and monocytes. It's aimed to determine that neopterin is a marker indicating necroinflammation and fibrosis levels in chronic hepatitis B infection. Materials and Methods: From January 4 to October 1, 2013 in Infections Diseases and Clinical Microbiology outpatient clinic and Gastroenterology outpatient clinic of our hospital, untreated, ? 18 years old volunteers that fulfilled criteria for diagnosis of chronic hepatitis B, had undergone liver biopsy in the last 1 year preceding the date of application and after application, were included. Neopterin levels in serum samples were investigated by ELISA. Results were correlated by HAI and fibrosis scores determined by liver biopsy. Results: In the 64 patients included in the study, relationship between serum neopterin levels and age, sex, serum ALT and serum HBV DNA levels were no statistically significant (p= 0.07, p=0.329, p=0.101, p=0.134). Positive correlation between serum neopterin levels, HAI and fibrosis scores was found statistically significant (p=<0.001, p=0.001). Sixteen (%25) HBeAg (+) and 48 (%75) HBeAg (-) patients were detected. Both HBeAg positive and HBeAg negative patient group, serum neopterin levels correlated positively with HAI and fibrosis scores (p=0.009, p=0.034, p=0.002, p=0.011 ). Conclusion: T lymphocytes and macrophages leads to development of necroinflammation and fibrosis in chronic hepatitis B. During immune response, neopterin released from macrophages is thought to reflect the necroinflammation and fibrosis in liver. Positive correlation and statistically significant relationship between serum neopterin levels, HAI and fibrosis scores were shown. Therefore neopterin is admitted to be a promising marker of fibrosis and necroinflammation in chronic hepatitis B infection. Key Words: Neopterin, necroinflammmation, fibrosis, hepatitis B