Somali Mogadişu Hastanesinde Hepatit C Virüsü Enfeksiyonunun İzlenmesinde Dolaylı Biyobelirteçlerin Değeri

Amaç: Somali Mogadişu Hastanesi’ne başvuran Hepatit C virüsü enfeksiyonu [anti-HCV (+)] olan hastaların laboratuvar testlerinde, karaciğer hastalığının ilerlemesini öngören Sınıf II fibrozis belirteçlerinin değerini ve trombosit parametrelerindeki değişiklikleri araştırmayı amaçladık. Gereç ve Yöntemler: Hastanemizde muayene edilen 18 yaş üstü tüm hastalar çalışmaya dahil edildi. CBC ve hastalardan alınan biyokimyasal ölçüm sonuçları eşliğinde, dolaylı karaciğer fibrozu (Sınıf II) belirteçleri AAR (AST/ALT oranı), APRI (AST/Plt oran indeksi) ve FIB-4 indeksi (Yaş (yıl) x AST (U/L) ) / [Platelet sayısı (109 / L)] x (ALT) 1/2 (U / L)], MPV/Platelet oranı, APRI = [(kişi AST/AST referans üst limiti) x Trombosit (103 /ml) x 100] hesaplandı. Bulgular: Çalışmamıza medyan yaşı 51 (32-67) yıl olan 1.605 (%55.6) erkek ve 1.282 (%44.4) kadın olmak üzere toplam 2.887 hasta dahil edildi. Erkeklerde anti-HCV pozitiflik oranı kadınlara göre 1,5 kat daha yüksek bulundu. Karaciğer hasarının dolaylı belirteçleri olan APRI, MPV / Plt R ve RPR düzeyleri, anti-HCV (+) olan hastalarda kontrol grubuna göre daha yüksek bulundu (p

The Value of Indirect Biomarkers in the Monitoring of Hepatitis C Virus Infection at the Mogadishu Hospital, Somalia

Aim: We aimed to investigate the value of Class II fibrosis markers as predictors of liver disease progress, and changes in platelet parameters in the laboratory tests of patients with Hepatitis C virus infection [anti-HCV (+)]admitted to the Somalia Mogadishu Hospital. Material and Methods: All patients older than 18 years old, who were examined in our hospital’s were included in the study. Accompanied by CBC and biochemical measurement results from patients, indirect liver fibrosis (Class II) markers AAR (AST/ALT ratio), APRI (AST/Plt ratio index) and FIB-4 index (Age (year) x AST (U/L) / [Platelet count (109 / L)] x (ALT) 1/2 (U / L)], MPV/Platelet ratio, APRI = [(person AST/AST reference upper limit) x Platelet (103 /ml) x 100] were calculated. Results: A total of 2,887 patients, 1,605 (55.6%) male and 1,282 (44.4%) female, with a median age of 51 (32-67) years, were included in our study. The anti-HCV positivity rate was found to be 1.5 times higher in men than women.APRI, MPV / Plt R and RPR levels, indirect markers of liver damage, were found to be higher in patients with anti-HCV (+) than those in the control group (p

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1. Averhoff FM, Glass N, Holtzman D. Global burden of hepatitis C: Considerations for healthcare providers in the United States. Clin Infect Dis 2012;55(suppl_1):S10-15.
2. Daw MA, Dau AA. Hepatitis C virus in Arab world: A state of concern. Scientific World Journal 2012;2012:719494.
3. Hassan-Kadle MA, Osman MS, Ogurtsov PP. Epidemiology of viral hepatitis in Somalia: Systematic review and meta-analysis study. World J Gastroenterol 2018;24(34):3927-3957.
4. Loggi E, Vukotic R, Conti F, Gitto S, Andreone P. Gold standard assays for the monitoring of patients with chronic hepatitis C. Future Virol 2018;13(8):529-537.
5. Misdraji J. Changing indications for liver biopsy: Viral hepatitis. Diagnostic Histopathol 2014;20(3):119-124.
6. Giannini E, Risso D, Botta F, Chiarbonello B, Fasoli A, Malfatti F, Romagnoli P, Testa E, Ceppa P, Testa R. Validity and clinical utility of the aspartate aminotransferase-alanine aminotransferase ratio in assessing disease severity and prognosis in patients with hepatitis C virus-related chronic liver disease. Arch Intern Med 2003;163(2):218-224.
7. Karagoz E, Ulcay A, Tanoglu A, Kara M, Turhan V, Erdem H, Oncul O, Gorenek L. Clinical usefulness of mean platelet volume and red blood cell distribution width to platelet ratio for predicting the severity of hepatic fibrosis in chronic hepatitis B virus patients. Eur J Gastroenterol Hepatol 2014;26(12):1320- 1324.
8. Shao LN, Zhang ST, Wang N, Yu WJ, Chen M, Xiao N, Duan Y, Pan LZ, Song WQ, Xia YX, Zhang L, Qi N, Liu M, Zhou SH. Platelet indices significantly correlate with liver fibrosis in HCV- infected patients. PLoS One. 2020;15(1):e0227544.
9. Eminler AT, Ayyildiz T, Irak K, Kiyici M, Gurel S, Dolar E, Gulten M, Nak SG. AST/ALT ratio is not useful in predicting the degree of fibrosis in chronic viral hepatitis patients. Eur J Gastroenterol Hepatol 2015;27(12):1361-1366.
10. Guéchot J, Boisson RC, Zarski J-P, Sturm N, Calès P, Lasnier E. AST/ALT ratio is not an index of liver fibrosis in chronic hepatitis C when aminotransferase activities are determinate according to the international recommendations. Clin Res Hepatol Gastroenterol 2013;37(5):467-472.
11. Haklar G. Liver function tests in chronic viral hepatitis cases. Marmara Med J 2016;29(4):6.
12. Reedy DW, Loo AT, Levine RA. AST/ALT ratio > or = 1 is not diagnostic of cirrhosis in patients with chronic hepatitis C. Dig Dis Sci 1998;43(9):2156-2159.
13. Castéra L, Vergniol J, Foucher J, Le Bail B, Chanteloup E, Haaser M, Darriet M, Couzigou P, De Lédinghen V. Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology 2005;128(2):343-350.
14. Canbakan M, Senturk H, Canbakan B, Toptas T, Tabak O, Ozaras R, Tabak F, Balcı H, Sut N, Ozbay G. Validation of biochemical markers for the prediction of liver fibrosis and necroinflammatory activity in hemodialysis patients with chronic hepatitis C. Nephron Clin Pract 2011;117(3):c289-295.
15. Lin ZH, Xin YN, Dong QJ, Wang Q, Jiang XJ, Zhan SH, Sun Y, Xuan SY. Performance of the aspartate aminotransferase-to- platelet ratio index for the staging of hepatitis C-related fibrosis: An updated meta-analysis. Hepatology 2011;53(3):726-736.
16. Sterling RK, Lissen E, Clumeck N, Sola R, Correa MC, Montaner J, S Sulkowski M, Torriani FJ, Dieterich DT, Thomas DL, Messinger D, Nelson M; APRICOT Clinical Investigators. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology 2006;43(6):1317-1325.
17. Taefi A, Kirthi CH, Suzan K. Red cell distribution width to platelet ratio, a useful indicator of liver fibrosis in chronic hepatitis patients. Hepatol Int 2015;9(3):454-460.
18. He Q, He Q, Qin X, Li S, Li T, Xie L, Deng Y, He Y, Chen Y, Wei Z. The relationship between inflammatory marker levels and hepatitis C virus severity. Gastroenterol Res Pract 2016;2016:2978479.