Predictive value of serum globulin levels for the extent of hepatic fibrosis i

liver411

Journal of Viral Hepatitis
Volume 13 Page 671  - October 2006
doi:10.1111/j.1365-2893.2006.00744.x
Volume 13 Issue 10


Predictive value of serum globulin levels for the extent of hepatic fibrosis
in patients with chronic hepatitis B infection

H. Schmilovitz-Weiss1, A. Tovar2, M. Halpern2, J. Sulkes3, M. Braun4, Y.
Rotman4, R. Tur-Kaspa4 and Z. Ben-Ari4

Summary. The mechanism underlying disease progression in hepatitis B virus
(HBV) infection is unknown. Immunoglobulins stimulate the proliferative
activity of rat hepatic stellate cells in vitro. A strong association was
found between serum immunoglobulin levels and hepatic fibrosis in patients
with hepatitis C virus infection. Our objective was to determine if the same
index could also be used in patients with chronic HBV infection. The records
of 100 patients with biochemical, serological, virological and histological
evidence of chronic HBV infection were reviewed for background factors and
serum globulin and immunoglobulin levels. Mean (㊣SD) patient age was 44.0
㊣ 14.7 years; 80 (80%) were male. Of the factors found to be significant on
univariate analysis, the only significant predictors of severe hepatic
fibrosis (stage ≡2) on multivariate analysis were serum globulin level
[odds ratio (OR) 5.97, 95% confidence intervals (CI) 1.82每19.53, P =
0.0004], platelet count (OR 0.98, CI 0.97每0.99, P = 0.001), and
immunoglobulin G (IgG) level (OR 1.003, CI 1.000每1.007, P < 0.042) but not
IgA, alkaline phosphatase, albumin or international normalized ratio. For
each increase of 0.33 mg/dL in serum globulin, there was a 0.5 point
increase in the stage of hepatic fibrosis. There appears to be a strong
association between levels of serum globulin and IgG and extent of hepatic
fibrosis in patients with chronic HBV infection. They can serve as
noninvasive markers of hepatic fibrosis and, if confirmed, have important
implications for the management of patients with chronic HBV infection

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