Serum Apolipoprotein A-Iv Level in HCV Related Liver Diseases

Title: Serum Apolipoprotein A-Iv Level in HCV Related Liver Diseases

Authors: Ibrahim E.H., Elyamany A.S., Dwedar F.I., Aly E.F.

DOI: http://dx.doi.org/10.18535/jmscr/v3i12.49

Abstract

Background: Hepatitis C virus (HCV) is a globally prevalent pathogen and chronic infection eventually causes cirrhosis leading to hepatocellular carcinoma (HCC) and ultimately death. Accurate assessment of liver fibrosis has become increasingly important as it allows for individualized management. Liver plays a key role in the metabolism of plasma apolipoproteins. Apolipoprotein A-IV (apoA-IV) is a component of intestinally derived, triglyceride-rich lipoproteins.

Objective: The present work was designed to study the level of apo A-IV in HCV related liver diseases.

Methods:Sixty treatment-naive patients with HCV related liver disease were enrolled in the study. They were classified as follow: twenty patients with chronic HCV infection (stage of fibrosis ≤ F3), twenty patients with HCV related liver cirrhosis, twenty patients with HCV related HCC and ten normal subjects as control. Serum level of apoA-IV was measured using enzyme linked immunosorbant assay (ELISA). Liver biopsies from patients with chronic HCV were examined to assess histological activity grade and fibrosis stage according to METAVIR scoring system and triphasic CT for HCC patients was performed.

Results: Apo A-IV level was significantly lower in liver cirrhosis than chronic hepatitis patients with a cutoff point of ˂36.4 (p<0.001). The receiver operating characteristic (ROC) curve showed an area under the curve (AUC) of 0.990 (P < 0.001), a sensitivity of 100% and a specificity of 90% for diagnosis of cirrhosis. Also, it was significantly lower in liver cirrhosis than HCC patients with a cutoff point ≤25.1 (p<0.001). The ROC showed AUC of 0.876, a sensitivity of 80.0 % and a specificity of 93.33% for diagnosis of HCC.

Conclusion: Serum apo A-IV showed bi-modal elevation in HCV related liver diseases and could be used as a noninvasive marker for liver cirrhosis in patients with chronic HCV infection and could be a promising marker for early detection of HCC in HCV hepatic cirrhosis.

Key words: (Apolipoprotein A-IV, Hepatitis C Virus, Liver cirrhosis, Hepatocellular carcinoma)

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Corresponding Author

Aly E.F.

Department of Internal Medicine

University of Alexandria, Egypt