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High sCD163 levels predicted fibrosis in patients with HCV, HBV

Increased levels of soluble CD163 were independently associated with fibrosis among patients with chronic hepatitis C virus and chronic hepatitis B virus, according to data from a recent study.  

In a cross-sectional study conducted at Westmead Hospital, Australia, 551 treatment-naive patients with chronic HCV and 203 treatment-naive patients with chronic HBV underwent liver biopsy and provided clinical data to use in multiple analyses in determining whether soluble CD163 (sCD163) is a marker for fibrosis. Researchers also created two sCD163-based fibrosis scores, CD163-HCV-HS and CD163-HBV-FS, and used them in regression analyses with Scheuer fibrosis score to determine whether sCD163 was directly associated with fibrosis or a marker for fibrosis when adjusted for various parameters. 

Results indicated that sCD163 levels were higher in patients with HCV (3.6; interquartile range, 2.5 mg/L-5.4 mg/L) compared with patients with HBV (2.4; interquartile range, 1.8 mg/L-3.6 mg/L; P<.001). sCD163 was associated for fibrosis stage in patients with HCV (OR=1.49; 95% CI, 1.38-1.61) and HBV (OR=1.32; 95% CI, 1.17-1.49), with the highest levels being among patients with fibrosis and cirrhosis. Patients with HCV also had higher scores for Scheuer fibrosis score (P=.001) and Scheuer portal inflammation (P<.001) and steatosis (P<.001) compared with patients with HBV. Patients with HCV showed associations between sCD163 and homeostatic model assessment of insulin resistance (HOMA-IR), but not among patients with HBV.

Areas under the receiver operating characteristics curve for CD163-HCV-FS (0.79; 95% CI, 0.74-0.83) and CD163-HBV-FS (0.71; 95% CI, 0.62-0.79) accurately showed fibrosis. CD163-HCV-FS, but not CD163-HBV-FS, was greater in quality in measuring aspartate aminotransferase-to-platelet ratio index (APRI) for all fibrosis stages and FIB-4 for fibrosis compared with current fibrosis scores.

“We demonstrated that Kupffer cells are activated in chronic viral hepatitis, and that the degree of macrophage activation as assessed by sCD136 levels increases with disease severity and is independently associated with histological fibrosis stage,” the researchers wrote. “Moreover, a sCD163-based fibrosis score was superior to the existing scores APRI and FIB-4 for significant fibrosis in HCV patients, presenting a promising tool for the noninvasive diagnosis of fibrosis in these patients.”

Disclosure: The researchers report no relevant financial disclosures.