Serum lymphocyte count and aspartate aminotransferase product score as a non-invasive marker for liver necroinflammation with or without fibrosis in chronic hepatitis b infection

Title : Serum lymphocyte count and aspartate aminotransferase product score as a non-invasive marker for liver necroinflammation with or without fibrosis in chronic hepatitis b infection

Abstract:

Introduction: Hepatitis B viral (HBV) infection is endemic in Africa with an estimated 82 million people being chronically infected. Liver biopsy remains the goal standard means of assessment of necro-inflammation and fibrosis in the liver. However, its various drawbacks as well as non-availability/non-affordability of fibroscan have led to the development of various serum-based non-invasive markers. Few non-invasive markers (which are currently not in routine clinical use) have been developed to assess for necro-inflammation within the liver in those with chronic hepatitis B infection (CHB) which is one of the parameters used to assess eligibility for commencement of antivirals in them unlike the widely used non-invasive markers for liver fibrosis
The aim of this study was to determine the accuracy of a novel serum-based non-invasive marker for liver necroinflammation termed LAP (Lymphocyte and AST Product) score and to assign a cutoff value that correlates with significant necroinflammation in CHB patients.
Methods: It was a retrospective hospital-based study carried out at OAUTHC Ile-Ife, Nigeria. The patients who had liver biopsy done on account of CHB with HBV DNA/ALT discordance at the Gastroenterology and Hepatology unit of the hospital from January 2020 to December 2023 were recruited for the study. Their records were retrieved and analyzed using SPSS version 26.0. LAP score was calculated for each of them, AUROC value was obtained and a cut off value was determined for significant necroinflammation.
Results: Sixty-six patients were recruited for the study with 50 (75.8%) males, 16 (24.2%) females, M:F of 8:2 and mean age of 33 ± 10years. AUROC value of 0.639 was obtained to get a cut off value of 1.80. The sensitivity, specificity, PPV and NPV of the LAP Score were also determined as 89.47%, 41.94%, 48.57% and 86.67% respectively.
Conclusion: The LAP score is a highly sensitive serum based non-invasive marker of liver necroinflammation which can be adopted for routine clinical use for determining eligibility for the commencement of antiviral in CHB patients.
Keywords: CHB, Necroinflammation; LAP score; AUROC.

Biography:

Dr. Raheem Yusuf Abiola studied Bachelor of Medicine; Bachelor of Surgery (MBBS) from Usmanu Danfodiyo University, Sokoto, Nigeria and graduated in 2014. He proceeded for his postgraduate residency training program in Internal Medicine and then in gastroenterology and hepatology subspecialty at University of Maiduguri Teaching Hospital, Maiduguri, Nigeria and Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria respectively and became a fellow of the West African College of Physicians in Gastroenterology in 2024. He also has a Masters degree in health planning and Management in 2019 from University of Maiduguri. He has keen interest in immunotherapeutics for chronic hepatitis B infection. He has published article in peer-review journals. He is married with children.