Chronic hepatitis C virus infection: Serum biomarkers in predicting liver damage

VALVA P; RIOS D; DE MATTEO E; PRECIADO MV

WORLD JOURNAL OF GASTROENTEROLOGY

W J G PRESS

Lugar: Beijing; Año: 2016 vol. 22 p. 1367 - 1381

1007-9327

Nowadays, one of the major clinical challenges is finding the best means for evaluating liver impairment and managing the increasing number of Hepatitis C virus infected patients. Prognosis and treatment of chronic hepatitis C (CHC) are partly dependent on the assessment of histological activity, namely cell necrosis and inflammation, and the degree of liver fibrosis. These parameters have so far been provided by liver biopsy; however, in addition to the risks related to an invasive procedure, liver biopsy has been associated with sampling error mostly due to suboptimal biopsy size. To avoid these pitfalls, several markers have been proposed as non-invasive alternatives for liver damage diagnosis. Distinct approaches among the currently available non-invasive methods: (i) the physical ones based on imaging techniques and (ii) the biological ones based on serum biomarkers will be discussed in this review; however, with special focus on currently available non-invasive serum markers. We will discuss: 1) class I serum biomarkers individually and as combined panels, particularly those which mirror the metabolism of liver extracellular matrix turnover and/or fibrogenic cell changes; 2) class II biomarkers that are indirect serum markers and are based on the evaluation of common functional alterations in the liver; and 3) biomarkers of liver cell death based on that hepatocyte apoptosis plays a significant role in the pathogenesis of HCV infection. The evidence behind the use of these markers will be highlighted, along with an assessment of diagnostic accuracy as well as advantages, limitations and application in clinical practice of each test for predicting liver damage in CHC.