IGFBP-1 TO 7 AS BIOMARKERS IN STAGES OF LIVER FIBROSIS DURING VIRAL HEPATITIS C

Introduction and Objectives

Diagnosis of liver disease (LD) is essential for the treatment and management of patients. The use of non-invasive methodologies is necessary despite the availability of direct-acting antivirals, some reports has been showed that treated patients can progress to cellular hepatocarcinoma (HCC). Continuous sampling that will evaluate liver tissue before and after treatment are essential for the prognosis of LD. Objective: To determine the sensitivity and specificity of insulin-like growth factor binding proteins (IGFBP) in the different stages of fibrosis in hepatitis C

Material and methods

A prospective, cross-sectional, observational study. The study included patients with CHC that were treatment naïve. The stages of fibrosis were classified as F0, 16 F1, F2, F3, or F4, according to international guidelines, through the FibroTest® and/or FibroScan® Patients with at-risk alcohol consumption (AUDIT>8), and without concordance between fibrosis diagnostic methods employed, and comorbidities were not included. Serum was obtained and multiple suspension array technology (Millipore®) was used to evaluated IGFBP-1,2, 3, 4, 5, 6, 7. Chi-square test, Mann-Whitney U test. Logistic regression models, odds ratios (ORs) and 5% confidence intervals were determined.

Results

A total of 128 patients diagnosed with CHC and 123 CT were included. Fibrosis stages were classified as follows: F0 (n=18), F1 (n=16), F2 (n=20), F3 (n=25), and F4 (n=48). IGFBP-1 to -7 showed an evident increment in patients mainly at F3 and F4. IGFBP-7 allows discriminate F3 vs F4 (72% sensibility, 62.5% specificity and cut of value of 2.74), whereas IGFBP-4 discriminates F3 vs F4 (83% sensibility, 68% specificity and cut of value of 14.68). P<0.001 was consider in statistical analysis.

Discussion

Although HCV treatment is available the progression from cirrhosis to HCC has been reported after clearance of HCV. Post-treatment studies evaluating the different stages of fibrosis should be performed. Therefore, the use of IGFBPs could be a tool in the continuous sampling previous and after treatment.

Conclusion

IGFBPs can be used as additional strategy for the diagnosis and discrimination of fibrosis stages in HCV.

Conflict of interest: The authors declare that there is no conflict of interest.

This work was partially financed by CONACyT SALUD-2016-272579 (GRG) and PAPIIT- UNAM TA200515 (GRG).