Dig Dis Sci: serum M2BPGi levels predict advanced fibrosis in patients with chronic hepatitis B virus infection

Chronic hepatitis B (CHB) affects approximately 292 million people worldwide, and there are many complications of CHB, including cirrhosis, decompensation, and/or hepatocellular carcinoma (HCC).

Identification of at-risk patients, particularly those with advanced liver disease or cirrhosis (F3/F4), is critical because prompt antiviral therapy can prevent disease progression and decompensation
.
Liver biopsy that allows for histological examination is considered the most accurate way to
assess fibrosis.
Over the past few decades, non-invasive models have been increasingly advocated to provide alternative assessments
for liver fibrosis.
The Mac-2-binding protein glycosylation isomer (M2BPGi), also known as Wisteria foribunda lectin-positive Mac2-binding protein (WFA+-M2BP), is a serum marker that has been extensively studied
as a potential marker of liver fibrosis in CHB patients.
To evaluate the role
of serum M2BPGi in predicting the persistence of advanced fibrosis in patients with chronic hepatitis B.

To this end, researchers prospectively recruited patients with chronic hepatitis B with advanced fibrosis or cirrhosis who were treated with nucleoside (t.
)analogue antiviral therapy≥ For 3 years, alanine aminotransferase is normal and serum HBV DNA is undetectable
.
Liver fibrosis was assessed using transient elastography (TE) and M2BPGi measurements at baseline and repeated
at 3 years.
Cirrhosis (LS) ≥ 9.
0 kPa and ≥ 12.
0 kPa define advanced fibrosis and cirrhosis
, respectively.

The results of the study showed that a total of 143 patients were enrolled (male:female = 101:42; median age 58.
7 years; 53.
8% had cirrhosis) and completed a paired assessment
.
The median baseline LS and M2BPGi were 12.
0 (IQR: 10.
5-18.
2) kPa and 0.
99 cut-off index (IQR: 0.
75-1.
74) (COI), respectively, with a 96%
agreement for diagnosing F3/F4.
Despite continued long-term antiviral therapy, 96 (67.
1%) patients had persistent advanced fibrosis or cirrhosis
at 3 years.
In multivariate analysis, baseline M2BPGi (OR 2.
128, 95% CI 1.
037–4.
366) and the presence of central obesity (OR 4.
648, 95% CI 1.
742–12.
402) were significantly associated
with persistent advanced fibrosis or cirrhosis within 3 years.
The baseline M2BPGi ≥ 1.
265 COI has a sensitivity of 50.
6% and 79
.
The specificity predicted for 3-year persistent advanced fibrosis or cirrhosis was 4% (area under the receiver operating characteristic curve: 0.
695).

Central obesity is associated with baseline M2BPGi ≥ the presence of a 1.
265 COI associated with persistent advanced fibrosis or cirrhosis at 3 years in 95.
7
% of patients.
HCC development was observed in 5 patients during follow-up, with a greater median increase in serum M2BPGi levels compared with those without HCC (46% versus 6.
2%, P = 0.
038).

This study confirmed that persistent advanced fibrosis or cirrhosis is observed in two-thirds of patients with chronic hepatitis
B despite effective antiviral therapy.
High serum M2BPGi and central obesity are associated
with a more than twofold and quadruple increased risk of persistent advanced fibrosis or cirrhosis, respectively.

Original source:

Lung-Yi Mak.
et al.
Role of Serum M2BPGi Levels in Predicting Persistence of Advanced Fibrosis in Chronic Hepatitis B Virus Infection.
Digestive Diseases and Sciences.
2022.