The Open Biomarkers Journal

ISSN: 1875-3183 ― Volume 11, 2021

Serum Markers as a Predictor of Hepatic Fibrosis Compared to Fibroscan in chronic hepatitis B Infected Egyptian patients: A Cross-sectional Study

Rehab Badawi1, Hanan Soliman1, Dina Ziada1, Mohammed Elhendawy1, Sherief Abd-Elsalam1, *, Marwa Salama1, Shaimaa Soliman2, Reham Gameaa1, Nehad Hawash1
1 Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt
2 Public Health and Community Medicine, Faculty of Medicine, Menoufia University, Al Minufya, Egypt


Background & Aims:

The gamma-glutamyl transpeptidase (GGT) to platelet ratio (GPR), the gamma-glutamyl transpeptidase to albumin (GAR) and S-index are novel biomarkers suggested to assess liver fibrosis. The aim of the work was to assess the correlation between GGT and other related markers as GAR and GPR among other previous documented markers and the degree of fibrosis and steatosis in chronic HBV Egyptian patients as measured by fibroscan.

Materials And Methods:

After ethical approval of the protocol, a total of 170 chronic HBV patients were recruited from tropical medicine department, Tanta University. They underwent fibroscan examination for fibrosis and steatosis measurement with concomitant testing of liver functions and complete blood picture. Proposed serum markers were calculated. The relation between these ratios with the fibrosis and steatosis measured by fibroscan were tested using Pearson rank correlation.


There was a highly significant positive correlation between gamma-glutamyl transpeptidase and platelet ratio (GPR), GAR, GGT, Fib4, APRI and fibrosis (p=<0.001, <0.001,<0.001,<0.001,0.011 and <0.001 respectively), while there was no correlation with the degree of steatosis (p=0.922,0.66,0.936,0.214,0.591 and 0.760 respectively). Also these markers were significantly higher in patients with higher grades of fibrosis (f2-4) (p= 0.007,0.013,<0.001,0.018,0.029,and 0.002 respectively), they also showed high sensitivity and low specificity in detecting higher grades of fibrosis with no statistically significant difference between the AUC of GPR and GAR (p=0.89).


Noninvasive serum markers including GGT, GPR, GAR, Fib4, APRI, and S-index are positively correlated to the degree of fibrosis in CHB patients with high sensitivity and low specificity. They were good negative tests for diagnosis of significant fibrosis.

Keywords: Fibrosis, Viral Hepatitis, Fibroscan, Markers, Cirrhosis, HBV.

Article Information

Identifiers and Pagination:

Year: 2020
Volume: 10
First Page: 69
Last Page: 75
Publisher Id: TOBIOMJ-10-69
DOI: 10.2174/1875318302010010069

Article History:

Received Date: 20/08/2020
Revision Received Date: 16/09/2020
Acceptance Date: 16/09/2020
Electronic publication date: 5/11/2020
Collection year: 2020

© 2020 Badawi et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University Hospital, El Geish Street, Tanta, Gharbia Governorate, Tanta, Egypt; Tel: 00201147773440; E-mail:

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