Assessing the Utility of Haematological and Non-invasive Fibrotic Indices for Chronic HBV infection Prognosis and Monitoring: A Pilot Study in a Ghanaian Population

Abstract Objective: Haematological and liver fibrotic markers could be appreciably utilized for effective monitoring of Hepatitis B viral (HBV) infection, thereby increasing patient’s treatment outcome. The objective of this study was to assess the applicability of complete blood count (CBC) and non-invasive liver-fibrotic indices as markers of prognostic outcome and monitoring in HBV infection. Results: Significant differences in levels of white cell and differentials counts, red blood cell count, hemoglobin indices, and platelet indices were observed between HBV-infected patients (cases) and uninfected persons (controls). Levels of haemoglobin (Hb), total white blood cells (tWBC), neutrophils, monocytes, platelets, and Platelet Distribution width (PDW) were significantly lower (p<0.05) in the cases compared to the controls. Total and indirect bilirubin; De-Ritis ratio, Aspartate transaminase-to-platelet ratio index (APRI) and RDW-to-platelet ratio (RPR) were elevated in cases compared with controls (p-value < 0.05). In a multivariate adjusted model to test the significance of markers, Hemoglobin Index (beta coefficient = -0.876, p-value<0.001), NLR (beta coefficient = -0.839, p-value<0.001), MPV_10000 (beta coefficient = -0.333, p-value<0.001) and Albumin (beta coefficient =-0.059, p-value = 0.014), were associated with HBV infection status. Receiver operative characteristics curve analysis showed Hemoglobin Index (AUC= 0.744) and MPV_10000 (AUC = 0.730) as better prognostic markers for HBV-infection.