The Value of Serum CA19-9 Levels in predicting Extent of Hepatic Fibrosis in Patients with Chronic Hepatitis B

and reliable is a priority.4 In addition to this, liver biopsy is not feasible in all hospitals of Bangladesh due to lack of expertise, limitation of prebiopsy investigations, ultrasonography, manpower, proper nursing care, post complication management, intensive care unit facilities, and lack of bed availability for hospital admission.The limitations of liver biopsy have led to the identification of alternative possibilities to assess liver fibrosis, mainly by noninvasive methods.CA19-9 is a tumor-associated antigen, shown to be upregulated in hepatocytes of patients with a significant increase in chronic hepatitis, fibrosis and cirrhosis, providing a marker for early detection of hepatic fibrosis.In developing countries with limited resources like Bangladesh, determination of serum CA19-9 level may be an excellent parameter to predict liver fibrosis.5 Moreover, the invasiveness, cost and life-threatening risk of liver biopsy can be avoided by measuring the level of serum CA19-9.In this study, measurement of serum CA19-9 was done in CHB patients to assess if the levels of serum ABSTRACTThis cross-sectional observational study was conducted to evaluate the implication of CA19-9 level in predicting the extent of hepatic fibrosis in patients with chronic hepatitis B (CHB).Fifty treatmentnaïve patients with CHB were divided into three groups: group I, patients with no fibrosis (F0; n = 3); group II, patients with mild fibrosis (F1; n = 25) and group III, patients with moderate fibrosis (F3; n = 22).There was no significant (p > 0.05) difference in levels of serum bilirubin, serum alanine aminotransferase, alkaline phosphatase, and alpha fetoprotein among groups I, II and III.Also, mean CA19-9 level did not differ among the three groups.It was observed that, for group II, AUC was 42.6%, sensitivity 52%, specificity 32%, considering cut-off value as 2.8 U/ml to predict F1 liver fibrosis.For group III, AUC was 57.7%, sensitivity 68%, specificity 50% considering cut-off value as 3.2 U/ml to predict F3 fibrosis.The levels of CA19-9 level do not seem to have significant predictive implication to assess hepatic fibrosis.