Clinical Utility of Plasma Osteopontin in HCV-Related Chronic Liver Disease Patients

Background: Osteopontin (OPN) is a secreted glycoprotein associated with various Clinico-Pathological conditions. How-ever, the clinical usefulness in the pathogenesis of liver disease remains obscure. Aim of the Study: We aimed to assess the clinical usefulness of OPN as a biomarker in determining disease severity of HCV-related chronic liver disease. Subjects and Methods: Forty patients with chronic HCV and 20 healthy controls were enrolled in this study. Routine investigations and assessment of liver histology were done. Plasma OPN levels were assessed using enzyme linked im-munosorbant assay (ELISA). Results: Plasma OPN level showed highly significant increase among HCV patients when compared to healthy controls. Also, plasma OPN levels were significantly higher in patients with higher histological activity index score (HAI) than those with mild HAI score and also in patients with extensive fibrosis when compared to those with mild fibrosis (p=0.001). Moreover, positive correlations were found between plasma OPN levels and liver enzyme (ALT, AST), serum bilirubin, Child Pugh score, HAI score and the severity of liver fibrosis. Negative correlation between serum albumin level and OPN was noted. Additionally, plasma OPN level was significantly elevated in patients with renal impairment and showed positive correlation with serum creatinine in chronic HCV patients. The sensitivity and specificity of OPN for prediction of fibrosis were 87% and 90% respectively, at a cutoff value of 4.9ng/ml. Osteopontin had area under curve value=0.91(CI; 0.84- 0.99), suggesting its good diagnostic accuracy in prediction of hepatic fibrosis. Conclusion: We concluded that OPN may play a role in the pathogenesis of hepatic inflammation and fibrosis and it is a good indicator for the severity of liver disease in HCV patients, suggesting that OPN is a biomarker affecting the pathogenesis and outcome of HCV.