GP73 Level in Patients with Chronic Hepatitis B: Relationship with Liver Biopsy, Levels of ALT, AST and HBV DNA: GP73 Level with Chronic Hepatitis B: ALT, AST and HBV DNA

Ratan Kumar Ramani; Sarwat Ashraf; Abdul Hayee Phulpoto; Safder Ali Pervez; Abdul Qayoom Memon; Asif Aziz

doi:10.54393/pjhs.v6i6.2821

Authors

Ratan Kumar Ramani Department of Medicine, Khairpur Medical College, Civil Hospital, Khairpur Mir's, Pakistan
Sarwat Ashraf Department of Medicine, Pir Abdul Qadir Shah Jillani Institute of Medical Sciences, Gambat, Pakistan
Abdul Hayee Phulpoto Department of Medicine, Khairpur Medical College, Civil Hospital, Khairpur Mir's, Pakistan
Safder Ali Pervez Department of Medicine, Khairpur Medical College, Civil Hospital, Khairpur Mir's, Pakistan
Abdul Qayoom Memon Department of Medicine, Khairpur Medical College, Civil Hospital, Khairpur Mir's, Pakistan
Asif Aziz Department of Medicine, Pir Abdul Qadir Shah Jillani Institute of Medical Sciences, Gambat, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i6.2821

Keywords:

Golgi Protein 73, Chronic Hepatitis B, Liver Diseases, Necro-Inflammations, Ishak Scoring System

Abstract

GP73 is a serum protein that increases with liver disease progression in chronic hepatitis B (CHB) and has been proposed as a marker for liver status monitoring. Objectives: To evaluate the correlation between GP73 levels, Histological Activity Index (HAI), and fibrosis stages in CHB patients, assessing its potential as a non-invasive biomarker. Methods: A cross-sectional study was conducted over six months (May to October 2024) at the Department of Infectious Diseases, Khairpur Medical College/Civil Hospital Khairpur. A total of 250 CHB patients were enrolled and categorized by fibrosis stages and HAI scores. GP73 concentrations were measured using ELISA. Patients were classified based on fibrosis stage (F0-F4) and HAI scores, determined through liver biopsy, with F0 representing no fibrosis and F4 indicating cirrhosis. Statistical analysis included one-way ANOVA, Kruskal-Wallis test, and correlation analysis. Results: GP73 levels increased progressively with fibrosis stages: 5.3 ng/mL in Group 1, 6.1 ng/mL in Group 2, and 7.5 ng/mL in Group 3 (p=0.001). GP73 also rose with HAI scores, from 5.0 ng/mL in minimal to 8.0 ng/mL in severe activity groups (p=0.05). GP73 showed a moderate correlation with fibrosis stage (r=0.6, p<0.05) and a strong correlation with HAI (r=0.75, p<0.001). Conclusions: GP73 is a promising non-invasive biomarker for evaluating liver fibrosis and necroinflammation in CHB, warranting further validation in larger studies.

References

Hsu YC, Huang DQ, Nguyen MH. Global burden of hepatitis B virus: current status, missed opportunities and a call for action. Nature reviews Gastroenterology and Hepatology. 2023 Aug; 20(8): 524-37. doi: 10.1038/s41575-023-00760-9. DOI: https://doi.org/10.1038/s41575-023-00760-9

Alsulaimany FA. Overview of Hepatitis B virus (HBV) Infection. Journal of King Abdulaziz University: Science. 2023 Jan; 33(1).

World Health Organization. Guidelines for the prevention, diagnosis, care and treatment for people with chronic hepatitis B infection. World Health Organization. 2024 Mar.

Iannacone M, Andreata F, Guidotti LG. Immunological insights in the treatment of chronic hepatitis B. Current Opinion in Immunology. 2022 Aug; 77: 102207. doi: 10.1016/j.coi.2022.102207. DOI: https://doi.org/10.1016/j.coi.2022.102207

Meng Z, Chen Y, Lu M. Advances in targeting the innate and adaptive immune systems to cure chronic hepatitis B virus infection. Frontiers in Immunology. 2020 Feb; 10: 3127. doi: 10.3389/fimmu.2019.03127. DOI: https://doi.org/10.3389/fimmu.2019.03127

Khanam A, Chua JV, Kottilil S. Immunopathology of chronic hepatitis B infection: role of innate and adaptive immune response in disease progression. International Journal of Molecular Sciences. 2021 May; 22(11): 5497. doi: 10.3390/ijms22115497. DOI: https://doi.org/10.3390/ijms22115497

Akbar SM, Yoshida O, Hiasa Y. Immune therapies against chronic hepatitis B. Journal of Gastroenterology. 2022 Aug; 57(8): 517-28. doi: 10.1007/s00535-022-01890-8. DOI: https://doi.org/10.1007/s00535-022-01890-8

Kaur N, Goyal G, Garg R, Tapasvi C, Chawla S, Kaur R. Potential role of noninvasive biomarkers during liver fibrosis. World journal of Hepatology. 2021 Dec; 13(12): 1919. doi: 10.4254/wjh.v13.i12.1919. DOI: https://doi.org/10.4254/wjh.v13.i12.1919

Szternel Ł, Sobucki B, Wieprzycka L, Krintus M, Panteghini M. Golgi protein 73 in liver fibrosis. Clinica Chimica Acta. 2024 Oct: 119999. doi: 10.1016/j.cca.2024.119999. DOI: https://doi.org/10.1016/j.cca.2024.119999

Gao Y, Wang M, Liu XN. Noninvasive serum markers for predicting significant liver histopathology in HBeAg-negative chronic HBV-infected patients with normal alanine aminotransferase. Microbiology Spectrum. 2024 Apr; 12(4): e03941-23. doi: 10.1128/spectrum.03941-23. DOI: https://doi.org/10.1128/spectrum.03941-23

Zoulim F, Chen PJ, Dandri M, Kennedy PT, Seeger C. Hepatitis B Virus DNA integration: Implications for diagnostics, therapy, and outcome. Journal of Hepatology. 2024 Jul. doi: 10.1016/j.jhep.2024.06.037. DOI: https://doi.org/10.1016/j.jhep.2024.06.037

Althubaiti A. Sample size determination: A practical guide for health researchers. Journal of General and Family Medicine. 2023 Mar; 24(2): 72-8. doi: 10.1002/jgf2.600. DOI: https://doi.org/10.1002/jgf2.600

Campbell C, Wang T, McNaughton AL, Barnes E, Matthews PC. Risk factors for the development of hepatocellular carcinoma (HCC) in chronic hepatitis B virus (HBV) infection: a systematic review and meta‐analysis. Journal of Viral Hepatitis. 2021 Mar; 28(3): 493-507. doi: 10.1111/jvh.13452. DOI: https://doi.org/10.1111/jvh.13452

Bousali M, Papatheodoridis G, Paraskevis D, Karamitros T. Hepatitis B virus DNA integration, chronic infections and hepatocellular carcinoma. Microorganisms. 2021 Aug; 9(8): 1787. doi: 10.3390/microorganisms9081787. DOI: https://doi.org/10.3390/microorganisms9081787

Li Y, Zhu Y, Gao D, Pan Y, Wang J, Zhang S et al. HBeAg-positive CHB patients with indeterminate phase associated with a high risk of significant fibrosis. Virology Journal. 2024 Nov; 21(1): 287. doi: 10.1186/s12985-024-02561-1. DOI: https://doi.org/10.1186/s12985-024-02561-1

Lee HA, Lee HW, Park Y, Kim HS, Seo YS. Hepatitis B core-related antigen is useful for predicting phase and prognosis of hepatitis B e antigen-positive patients. Journal of Clinical Medicine. 2022 Mar; 11(6): 1729. doi: 10.3390/jcm11061729. DOI: https://doi.org/10.3390/jcm11061729

Wang N, Zheng J, Huang Y, Pu X, Jiang L, Yang J. A Predictive Model to Evaluate the HbeAg Positivity of Chronic Hepatitis B Virus Patients in Clinics: A Cross-Sectional Study. Medicina. 2022 Sep; 58(9): 1279. doi: 10.3390/medicina58091279. DOI: https://doi.org/10.3390/medicina58091279

Duan M, Chi X, Xiao H, Liu X, Zhuang H. High-normal alanine aminotransferase is an indicator for liver histopathology in HBeAg-negative chronic hepatitis B. Hepatology International. 2021 Apr; 15: 318-27. doi: 10.1007/s12072-021-10153-2. DOI: https://doi.org/10.1007/s12072-021-10153-2

Xu C, Zhao Y, Chen H, Ren W, Yang X, Zheng W et al. Risk factors for significant histological changes in both HBeAg-positive and negative treatment-naive chronic hepatitis B with persistently normal alanine aminotransferase level. BioMed Central Infectious Diseases. 2024 Oct; 24(1): 1120. doi: 10.1186/s12879-024-10015-w. DOI: https://doi.org/10.1186/s12879-024-10015-w

Yao K, Wang J, Wang L, Xia J, Yan X, Wu W et al. Association of anti‐HBc and liver inflammation in HBeAg‐negative chronic hepatitis B virus‐infected patients with normal ALT and detectable HBV DNA. Journal of Medical Virology. 2022 Feb; 94(2): 659-66. doi: 10.1002/jmv.27327. DOI: https://doi.org/10.1002/jmv.27327

Pan S, Yu Y, Wang S, Tu B, Shen Y, Qiu Q et al. Correlation of HBV DNA and hepatitis B surface antigen levels with tumor response, liver function and immunological indicators in liver cancer patients with HBV infection undergoing PD-1 inhibition combinational therapy. Frontiers in Immunology. 2022 May; 13: 892618. doi: 10.3389/fimmu.2022.892618. DOI: https://doi.org/10.3389/fimmu.2022.892618

Zhang ZQ, Shi BS, Lu W, Liu DP, Huang D, Feng YL. Quantitative HBcrAg and HBcAb versus HBsAg and HBV DNA in predicting liver fibrosis levels of chronic hepatitis B patients. Gastroenterología y Hepatología (English Edition). 2020 Nov; 43(9): 526-36. doi: 10.1016/j.gastre.2020.03.005. DOI: https://doi.org/10.1016/j.gastre.2020.03.005

Gatselis NK, Tornai T, Shums Z, Zachou K, Saitis A, Gabeta S et al. Golgi protein-73: A biomarker for assessing cirrhosis and prognosis of liver disease patients. World Journal of Gastroenterology. 2020 Sep; 26(34): 5130. doi: 10.3748/wjg.v26.i34.5130. DOI: https://doi.org/10.3748/wjg.v26.i34.5130

Li Y, Yang Y, Li Y, Zhang P, Ge G, Jin J et al. Use of GP73 in the diagnosis of non-alcoholic steatohepatitis and the staging of hepatic fibrosis. Journal of International Medical Research. 2021 Nov; 49(11): 03000605211055378. doi: 10.1177/03000605211055378. DOI: https://doi.org/10.1177/03000605211055378