Laboratory Markers of Liver Damage in Chronic Hepatitis C
The aim of the investigation was to assess the availability of a combined study of biochemical tests, hyaluronic acid (HA), alpha-fetoprotein (AFP), malondialdehyde (MDA), catalase, cytokines, and leptin to determine the liver damage severity (fibrosis and cirrhosis stages) in patients with chronic hepatitis C (CHC). Materials and Methods. The study involved 100 patients with CHC during a reactivation stage. A control group consisted of 30 apparently healthy subjects. Hepatic density was measured by ultrasound elastography. In blood of CHC patients we determined biochemical measurements of transaminase and albumin, platelet count, HA concentration, tumor necrosis factor (TNF-α), vascular endothelial growth factor (VEGF), leptin, AFP level, MDA, and catalase activity. Results. CHC reactivation is characterized by the increase of HA (p=0.01), AFP (p=0.02), MDA (p<0.001), VEGF (p<0.001), TNF-α (p=0.001) and leptin (p=0.001) with a simultaneous decrease of platelet count (p=0.04) and catalase decreased activity (p<0.001). In CHC, all fibrosis stages in the liver enable to stratify the serum markers of HA and TNF-α, that is confirmed by their direct significant correlations with hepatic density according to ultrasound elastography (r=0.42; p=0.001 and r=0.41; p=0.001, respectively). The most pronounced increase in AFP, VEGF, MDA, and leptin in simultaneous decrease in albumin synthesis, catalase activity, and platelet count is observed in severe fibrosis. Conclusion. Serum concentrations of HA and TNF-α in CHC show the degree of hepatic tissue damage and can be used to stratify hepatic fibrosis stages. AFP, VEGF, MDA albumin, catalase, leptin concentration and platelet count can be used as accessory tests to diagnose severe fibrosis in CHC patients.