NONINVASIVE PARAMETERS AND STAGING OF LIVER FIBROSIS IN CHRONIC HEPATITIS C PATIENTS

OBJECTIVES: To use biochemical parameters and FibroScan as noninvasive tool in determination of various stages of liver fibrosis in chronic hepatitis C virus (HCV) patients. METHODS: Total 759 participants (609 chronic HCV patients and 150 normal healthy controls) were recruited from Lady Reading hospital and AI-Hayat Medical Center, Dabgri garden, Peshawar, Pakistan and analyzed for biochemical markers from February 2015 to January 2017. On the basis of liver stiffness, 609 HCV patients were categorized in 05 groups as per FibroScan findings that include patients with no fibrosis, mild fibrosis, moderate fibrosis, severe fibrosis and cirrhosis. Only those HCV patients who showed presence of HCV RNA (PCR assay) in serum were included in this study. HCV patients who were co-infected with Hepatitis B virus and HIV were excluded from this study. RESULTS: Advance staged disease patients with severe liver fibrosis and cirrhosis showed elevated level of aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), AST/ALT, total bilirubin and lower level of albumin and haptoglobinas compared to controls and were found statistically significant (P<0.01). Patients group with cirrhosis showed elevated level of AST, ALT, GGT, ALP, AST/ALT and total bilirubin when compared to patients group with no liver complications and were statistically significant (P <0.01). Albumin and haptoglobin were significantly lower (P<0.05) in cirrhotic patients compared to those without liver complications. CONCLUSION: Combination of FibroScan and routinely available biochemical parameters are helpful in identifying liver fibrosis and cirrhosis in chronic HCV patients.