Platelet to lymphocyte ratio as a predictive biomarker of liver fibrosis (on elastography) in patients with hepatitis C
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ORIGINAL ARTICLE
Platelet to lymphocyte ratio as a predictive biomarker of liver fibrosis (on elastography) in patients with hepatitis C virus (HCV)-related liver disease Roberto Catanzaro 1 & Morena Sciuto 1 & Cristina Lanzafame 1 & Baskar Balakrishnan 2 & Francesco Marotta 3 Received: 28 December 2019 / Accepted: 13 April 2020 # Indian Society of Gastroenterology 2020
Abstract Background Liver fibrosis is a frequent complication of chronic hepatitis C virus (HCV) infection. Its evaluation is very important for the prognosis of these patients. The aim of this study was to evaluate the possibility of exploiting the platelet to lymphocyte ratio and the neutrophil to lymphocyte ratio as non-invasive predictive markers of liver fibrosis. Methods We recruited 120 patients with chronic HCV infection. They were subjected to various clinical investigations to assess the severity of fibrosis. Transient elastography and some serological tests were performed, and the platelet to lymphocyte ratio and the neutrophil to lymphocyte ratio were estimated. Results Sixty-four patients had F4 fibrosis (defined by elastography) and their platelet to lymphocyte ratio (69.92 ± 26.47) was lower than in patients with non-F4 fibrosis (95.19 ± 48.15) (p = 0.001). The neutrophil to lymphocyte ratio was also estimated, but the difference between the 2 groups of patients was not significant statistically (p = 0.07). Conclusion The platelet to lymphocyte ratio can be used as a predictive biomarker of liver fibrosis, unlike the neutrophil to lymphocyte ratio which is not predictive of this HCV-related chronic hepatitis complication. More studies are needed to validate this hypothesis. Keywords Biomarkers . Hepatitis C infection . Inflammation . Liver disease . Liver fibrosis
Introduction Hepatitis C virus (HCV) infection is a disease that primarily affects the liver, but also extrahepatic tissues, such as peripheral blood mononuclear cell. It causes more than 300,000 deaths every year [1, 2]. The World Health Organization (WHO) evaluated that in 2015 over 70 million people were chronically infected (global prevalence 1%), about 390,000 died of cirrhosis or hepatocarcinoma (HCC), and about 1.75 million new HCV infections occurred. HCV infection represents a major public health problem, due to its large
* Roberto Catanzaro [email protected] 1
Department of Clinical and Experimental Medicine, Gastroenterology Section, “Gaspare Rodolico” Policlinico Hospital, University of Catania, Via Santa Sofia, 78, 95123 Catania, Italy
2
Department of Immunology, Mayo Clinic, Rochester, MN, USA
3
ReGenera R&D International for Aging Intervention & San Babila Clinic, Milan, Italy
distribution and its hepatic and extrahepatic manifestations, which make it a real burden for people infected [3]. There are 7 different genotypes of this virus and the most common in the world is genotype 1 (49.1% of HCV cases) [4]. The chronic inflammation caused by this virus predisposes to the development of liver diseases, including liver fibrosis. The evaluation of liver
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