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Background <p>Liver fibrosis, a critical outcome of chronic Hepatitis B (HBV) and Hepatitis C (HCV) infections, leads to severe complications such as cirrhosis and hepatocellular carcinoma (HCC). Traditional diagnostic methods, including liver biopsy, are invasive and challenging. This study evaluates non-invasive biomarkers like Hyaluronic Acid (HA), Cartilage Oligomeric Matrix Protein (COMP), and Type IV Collagen (CO IV), along with composite scores such as APRI and FIB-4, for diagnosing liver fibrosis in HBV and HCV patients.</p> Methods <p>A total of 211 participants were enrolled, including 68 HCV patients, 75 HBV patients, and 75 healthy controls. Liver biopsies were performed to determine fibrosis stages using the METAVIR scoring system. Biomarkers were measured using ELISA kits, and biochemical tests were conducted. Statistical analysis was performed to compare clinical and demographic parameters across groups, employing ROC curve analysis to assess the diagnostic accuracy of the biomarkers.</p> Results <p>HBV patients exhibited significantly higher levels of ALT, AST, HA, and COMP compared to healthy controls (<i>p </i>&lt; 0.001). ROC analysis revealed that non-invasive biomarkers, particularly HA and Type IV Collagen, provided substantial diagnostic accuracy for distinguishing advanced fibrosis (F3-F4) from early stages. Composite scores like APRI and FIB-4 were effective in detecting advanced fibrosis but less accurate for early-stage disease.</p> Conclusions <p>Non-invasive biomarkers, especially HA and CO IV, demonstrate promising potential for diagnosing liver fibrosis, offering a less invasive alternative to liver biopsy. These findings could lead to broader implementation of non-invasive diagnostics, improving patient outcomes and resource utilization, particularly in low-resource settings.</p> Graphical Abstract <p></p>

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Evaluating Non-Invasive Biomarkers and Composite Scores for Liver Fibrosis Diagnosis in Hepatitis B and C Infections

  • 期刊论文

  • 发表日期：

    2025年8月11日

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  • Tamer A. Addissouky,
  • Ibrahim El Tantawy El Sayed,
  • Ayman E. El Agroudy,
  • Yuliang Wang

摘要

Background

Liver fibrosis, a critical outcome of chronic Hepatitis B (HBV) and Hepatitis C (HCV) infections, leads to severe complications such as cirrhosis and hepatocellular carcinoma (HCC). Traditional diagnostic methods, including liver biopsy, are invasive and challenging. This study evaluates non-invasive biomarkers like Hyaluronic Acid (HA), Cartilage Oligomeric Matrix Protein (COMP), and Type IV Collagen (CO IV), along with composite scores such as APRI and FIB-4, for diagnosing liver fibrosis in HBV and HCV patients.

Methods

A total of 211 participants were enrolled, including 68 HCV patients, 75 HBV patients, and 75 healthy controls. Liver biopsies were performed to determine fibrosis stages using the METAVIR scoring system. Biomarkers were measured using ELISA kits, and biochemical tests were conducted. Statistical analysis was performed to compare clinical and demographic parameters across groups, employing ROC curve analysis to assess the diagnostic accuracy of the biomarkers.

Results

HBV patients exhibited significantly higher levels of ALT, AST, HA, and COMP compared to healthy controls (p < 0.001). ROC analysis revealed that non-invasive biomarkers, particularly HA and Type IV Collagen, provided substantial diagnostic accuracy for distinguishing advanced fibrosis (F3-F4) from early stages. Composite scores like APRI and FIB-4 were effective in detecting advanced fibrosis but less accurate for early-stage disease.

Conclusions

Non-invasive biomarkers, especially HA and CO IV, demonstrate promising potential for diagnosing liver fibrosis, offering a less invasive alternative to liver biopsy. These findings could lead to broader implementation of non-invasive diagnostics, improving patient outcomes and resource utilization, particularly in low-resource settings.

Graphical Abstract