Diagnostic Role of Serum Chitinase 3 Like Protein 1 as Potential Marker for Fibrosis Assessment in Patient with Chronic Hepatitis B Infection

Abstract

Abstract Objectives The main objective of this research was to study to evaluate the diagnostic accuracy of serum chitinase-3 like protein-1 (CHI3L1) in comparison with transient elastography (TE) and non- invasive indirect serum indices (Fib-4 and APRI) for the prediction of significant hepatic fibrosis in patients with chronic HBV infection. Methods The current cross-sectional was carried out on 30 individuals with CHB who attended the viral hepatitis unit outpatient clinic, Faculty of Medicine, Ain Shams University, from Aug-2021 to Mar-2022. The primary outcome measures are the correlation of CHI3L1 level to TE, Fib-4, and APRI and calculating the sensitivity and specificity. Results The mean age of CHB cases enrolled was 41.60 ± 11.68 years. Male accounted for 21(70%) of cases. The serum level of CHI3L1 was statistically significantly higher in the enrolled patients' group (CHB) median (IQR): 317.5 (300 – 380) ng/ml than healthy control group 28 (25 – 35) with a p-value <0.001. The results of the current study showed a highly significant (p < 0.001) positive correlation (r = +0.702) between CHI3L1 and TE. However, no statistically significant correlations have been found between the level of CHI3L1 and either Fib-4 or APRI. CHI3L1 levels were significantly higher in CHB patients with significant hepatic fibrosis than in those without significant fibrosis in our study. ROC curve shows that CHI3L1 at the cut-off > 307.5 can differentiate between patients with significant fibrosis and patients with no or mild fibrosis according to TE with a sensitivity of 85.5%, specificity of 62.5%, and area under the curve (AUC) of 0.80 (95% CI: 0.64-0.96). Our study showed that significant fibrosis had been found more in older age. The higher the CHI3L1 serum levels, the higher the degree of hepatic fibrosis. Conclusion In conclusion, as the CHI3L1 levels were significantly higher in CHB patients with significant hepatic fibrosis than in those without significant fibrosis, the beneficial effect of CHI3L1 for the prediction of significant hepatic fibrosis in patients with chronic HBV infection has some evidence.