Diagnostic Value of the Quantitative Titer of High-Sensitivity C-Reactive Protein in the Detection of Clinical Stages of Chronic Hepatitis B Infection

Abstract

Background: Detection of the clinical phase of chronic hepatitis B virus (HBV) infection is highly important in determining the treatment protocol. The aim of this study was to evaluate the diagnostic value of high-sensitivity C-reactive protein (hs-CRP) level as a non-invasive parameter in distinguishing different phases of chronic HBV infection. Methods: In this cross-sectional study, 163 patients with chronic HBV infection were studied in Zahedan, Iran in 2015. The patients were classified into different phases of chronic HBV infection, based on the criteria recommended by the European association for the study of the liver (EASL). The serum level of hs-CRP was compared between different groups, using Mann-Whitney U test and Kruskal-Wallis test. Receiver operating characteristic (ROC) curve analysis was also used to investigate the predictive value of serum hs-CRP level in distinguishing cases of active HBV infection from inactive carriers. Results: The present study included data from 163 patients with chronic HBV infection (males: 110, 68.3%; females: 53, 31.7%). Based on the findings, hs-CRP level was 2.3 ± 5.8 mg/L in patients with chronic HBV infection and 1.6 ± 2.5 mg/L in inactive carriers (P = 0.449). The optimal hs-CRP cut-off point for differentiation of chronic carriers was identified as 0.27 mg/L, with sensitivity, specificity, and positive and negative predictive values of 62.7%, 48.1%, 15.1%, and 99.9%, respectively. Conclusions: The present study showed that serum hs-CRP level is not a predictive marker for the clinical phase of chronic HBV infection. Given its low specificity and sensitivity, hs-CRP level should be evaluated along with the viral load and other variables for determining the severity of chronic HBV infection.