Correlation of biological serum markers with the degree of hepatic fibrosis and necroinflammatory activity in hepatitis C and schistosomiasis patients

• Published in: Memórias do Instituto Oswaldo Cruz 2010-07, Vol.105 (4), p.460-466
• Main Authors: de Morais, Clarice Neuenschwander Lins, Carvalho, Bruno de Melo, de Melo, Wlademir Gomes, de Melo, Fábio Lopes, Lopes, Edmundo Pessoa de Almeida, Domingues, Ana Lúcia Coutinho, Jucá, Norma, Martins, João Roberto Maciel, Diniz, George Tadeu Nunes, Montenegro, Silvia Maria Lucena
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Analysis of Variance; biological markers; biological markers - hepatic fibrosis - HC - schistosomiasis; Biomarkers - blood; Case-Control Studies; hepatic fibrosis; Hepatitis C - blood; Hepatitis C - complications; Hepatitis C - pathology; Humans; Liver Cirrhosis - blood; Liver Cirrhosis - complications; Liver Cirrhosis - pathology; Liver Diseases, Parasitic - blood; Liver Diseases, Parasitic - complications; Liver Diseases, Parasitic - pathology; Middle Aged; Necrosis - pathology; PARASITOLOGY; ROC Curve; schistosomiasis; Schistosomiasis - blood; Schistosomiasis - complications; Schistosomiasis - pathology; Severity of Illness Index; Splenic Diseases - blood; Splenic Diseases - complications; Splenic Diseases - pathology; TROPICAL MEDICINE; Young Adult
• ISSN: 1678-8060; 0074-0276; 1678-8060; 0074-0276
• DOI: 10.1590/S0074-02762010000400018

Liver biopsy is the gold-standard method to stage fibrosis; however, it is an invasive procedure and is potentially dangerous. The main objective of this study was to evaluate biological markers, such as cytokines IL-13, IFN-γ, TNF-α and TGF-β, platelets, bilirubins (Bil), alanine aminotransferase (ALT) and aspartate aminotransferase (AST), total proteins, γ-glutamil transferase (γ-GT) and alkaline phosphatase (AP), that could be used to predict the severity of hepatic fibrosis in schistosomiasis and hepatitis C (HC) as isolated diseases or co-infections. The following patient groups were selected: HC (n = 39), HC/hepatosplenic schistosomiasis (HSS) (n = 19), HSS (n = 22) and a control group (n = 13). ANOVA and ROC curves were used for statistical analysis. P < 0.05 was considered significant. With HC patients we showed that TNF-α (p = 0.020) and AP (p = 0.005) could differentiate mild and severe fibrosis. With regard to necroinf lammatory activity, AST (p = 0.002), γ-GT (p = 0.034) and AP (p = 0.001) were the best markers to differentiate mild and severe activity. In HC + HSS patients, total Bil (p = 0.008) was capable of differentiating between mild and severe fibrosis. In conclusion, our study was able to suggest biological markers that are non-invasive candidates to evaluate fibrosis and necroinf lammatory activity in HC and HC + HSS.