Diagnostic role of fibromarkers and oncomarkers in relation to the rate of progression to cirrhosis in chronic hepatitis C

Liver fibrosis is the process of replacement of liver cells by connective tissue, leading to the development of liver failure. One of the main causes of fibrosis with subsequent formation of liver cirrhosis and hepatocellular carcinoma (HCC) is chronic viral hepatitis C. The abundance of existing approaches to noninvasive diagnosis of liver fibrosis and HCC stage requires a systematic analysis of them. Objective. To evaluate the diagnostic role of individual fibrosis indicators and oncomarkers depending on the rate of fibrosis progression to cirrhosis in chronic viral hepatitis C. Patients and methods. The study was conducted in the clinic of the Research Institute of Virology of the Republican Specialized Scientific and Practical Medical Center of Epidemiology, Microbiology, Infectious and Parasitic Diseases. Patients with rapid progression of liver fibrosis (40.6%) and slow progression of liver fibrosis (59.4%) were included in the study. General and biochemical blood tests, polymerase chain reaction (determination of hepatitis C virus – HCV RNA), ultrasound and liver fibroscanning were performed. APRI index and alpha-fetoprotein (AFP) score were determined in the work. There were 56.2% males and 43.8% females. The age of patients ranged from 19 to 75 years (median was 41.7 years). Results. Significantly high degrees of hepatic tissue density by elastometry were found in the examined patients with fast rate of liver fibrosis progression in chronic hepatitis C. Fast LFR was predicted by APRI value >0.75 and AFP >3.24 IU/mL, and slow LFR by ≤0.75 and ≤3.24 IU/mL, respectively. APRI and AFP values were 1.8- and 1.2-fold higher in fast hepatic SPF patients, respectively, than in slow SPF patients (p < 0.01 and p < 0.05, respectively). Conclusion. To differentiate the stage and rate of liver fibrosis progression it is optimal to use the determination of indirect indicators of fibrosis – APRI index and AFP oncomarker, which are considered as predictors of fibrosis progression, predicting the risk of liver fibrosis transition to cirrhosis in chronic hepatitis C.