Evaluation of serum fibrotic markers; CTGF, IL-17and TGF-β1 versus liver biopsy for detection of hepatic fibrosis in Egyptian patients with chronic hepatitis C

Objectives Hepatitis C virus (HCV) infection in Egypt is the most serious health problem, where 10%–15% of the population is infected. The severity of the disease and diagnostic decision-making is evaluated by liver biopsy; an invasive technique with many drawbacks. Recently, attention has been directed to non-invasive, accurate alternatives using serum biochemical markers. Thus, CTGF, IL-17and TGF-β1 were assessed versus liver biopsy in relation to hepatic inflammatory and fibrotic status in chronic HCV patients. Design and methods 58 chronic HCV patients and 30 normal healthy controls were enrolled in the study. Serum samples were collected for detection of CTGF, IL-17and TGF-β1 levels using ELISA. Liver biopsies were obtained from some patients for revaluation of the expression levels of the studied biomarkers genes by quantitative Real Time PCR and for histopathological assessment of grades of inflammation and stages of fibrosis. Results CTGF, IL-17and TGF-β1serum levels were significantly higher in HCV patients versus healthy controls, and decreased significantly in response to antiviral therapy. There were significant differences in their serum levels and the relative expression levels of their genes in relation to hepatic fibrotic stages and inflammatory grades. Significant Correlation existed between the Serum levels of measured biomarkers and the relative expression levels of their genes in the corresponding liver tissue; verifying the hepatic source of serum biomarkers. Conclusion CTGF, IL-17and TGF-β1are serum promising biomarkers, being non-invasive, specific, sensitive and accurate method for assessment of liver fibrosis and inflammation in Chronic HCV infection. They could be alternatives to invasive liver biopsy.