Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics

In children, liver biopsy (LB) is a standard method used for obtaining liver tissue for histopathological evaluation. There are several noninvasive diagnostic methods for determining liver fibrosis that are being validated such as blood markers and imaging methods fibroscan (TE).The aim of the current study is to identify the accuracy of fibrosis serological markers & TE in relation to LB (based on Ishak scoring system) in children with chronic viral hepatitis infections. We studied 50 children with chronic viral hepatitis (14 infected with hepatitis B virus (HBV), 35 infected with hepatitis virus (HCV) & 1 with both) and 20 controls. Our results showed that their mean age ± SD is 11.8 ± 3.5 years. Aspartate aminotransferase to platelet ratio index (APRI) can predict fibrosis with a sensitivity of 65.1% and specificity of 57.1% in patients with chronic viral hepatitis with no significance difference between levels in different stages of fibrosis. APRI median level was higher in children with HBV infection than in children with HCV infection with no statistical difference. There is a negative correlation between each parameter (weight & height) and hyaluronic acid (HA) which is statistically significant. There is no significant statistical difference between cases and controls in HA level. HA can predict fibrosis with a sensitivity of 60.5% and specificity of 71.4% in patients with chronic viral hepatitis with no significance difference between HA levels in different stages of fibrosis. TE can predict fibrosis with a sensitivity of 60.5% and specificity of 85.7% in patients with chronic viral hepatitis with a higher significance in group with moderate to severe fibrosis compared to no to mild group.APRI, HA and TE are good predictors of presence of fibrosis almost with the same accuracy. TE is the only method to differentiate cases with mild from those with significant fibrosis

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