الفهرس 
HBV infectionOnly 14 pages are availabe for public view
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Abstract
Hepatitis B virus related fibrosis or cirrhosis is a progressive disease, ultimately resulting in end-stage liver disease or hepatocellular carcinoma (HCC). Therefore, the detection and quantification of liver fibrosis is a key factor for disease management and prognostication for an individual with HBV.
Liver biopsy as been t e “gold standard” for liver fibrosis staging for decades. However, liver biopsy is a costly and invasive procedure. Therefore, the growing need for alternative approach to the assessment of liver disease severity has driven the development of several non-invasive methods in order to overcome the limitations of liver biopsy. The application of these techniques in the setting of hepatitis B viral disease for both the assessment of liver fibrosis and the prediction of liver-related complications can lead to improved patient management. Both blood and imaging based approaches have advantages over liver biopsy, including minimal risks, lower cost, better patient acceptance and speed of results, while disadvantages include lower diagnostic accuracy in intermediate disease stages and variability with co-existing hepatic inflammation or steatosis.This study was carried out in Cairo Fatemic hospital viral hepatitis unit on 50 patients attending the clinic and 20 normal individuals as a control group over the period from July 2019 till January 2020.
All studied patients were subjected to the following:
1. Full history taking (e.g. age, gender, Alcohol intake, family history of HCC, weight loss {non-intentional loss of weight more than 10% over 10 months}, jaundice, increased abdominal girth, GI bleeding, disturbed consciousness or other chronic diseases).
2. Clinical examination (General and abdominal examination).
3. Laboratory investigations including: complete blood count, prothrombin concentration, AST (Aspartate Aminotransferase), ALT (Alanine Amino-transferase), serum bilirubin level (total), Alfa Feto-protein (AFP), Hepatitis B virus (HBV) DNA levels, HBs Ag and HBeAg.
4. Assessment of liver fibrosis by the following non-invasive methods:
a) Indirect serum indices: APRI and Fibrosis index (FIB4).
b) Serum M2BPGi assay
c) Transient elastography (Fibroscan®).Patients were classified according to their Fibroscan® values into 4 groups: (F0-F1); includes 27 patients (54%), (F2); includes 11 patients (22%), (F3); includes 3 patients (6%) and (F4); includes 9 patients (18%).
According to the diagnostic accuracy of M2BPGi:
For diagnosing F2-F3, the AUROC of serum M2BPGi was 0.993 with the optimal cutoff value 1.02 COI with sensitivity and specificity 100% & 92.6% respectively.
For diagnosing F4, the AUROC of serum M2BPGi was 1 with the optimal cutoff value 1.71 COI with sensitivity and specificity 100% & 100% respectively.