Wisteria floribunda agglutinin-positive Mac-2-binding protein in the prediction of disease severity in chronic hepatitis B patients

BACKGROUND: Wisteria floribunda agglutinin-positive Mac-2-binding protein (WFA(+)-M2BP) was a novel marker of liver fibrosis. We aimed to investigate WFA(+)-M2BP level in assessing liver fibrosis in patients with chronic hepatitis B (CHB) infection. METHODS: A total of 160 CHB patients, who received a liver biopsy, were consecutively recruited. Serum WFA(+)-M2BP level was quantified at the time point of biopsy. The results were compared with histopathological manifestations and clinical characteristics of the patients. RESULTS: The median WFA(+)-M2BP level, aspartate aminotransferase-to-platelet ratio (APRI) and Fibrosis-4 (FIB-4) index were 1.20 COI, 1.19, and 1.63, respectively. Fifty-one (31.9%) patients had advanced fibrosis. There was a significant increase of WFA(+)-M2BP levels in parallel to necroinflammation/fibrosis stages. The areas under the receiver operating characteristic curve (AUROC) of WFA(+)-M2BP level for predicting fibrosis stages were 0.780 of F2, 0.785 of F3, and 0.769 of F4, respectively (all p <0.001). The multivariate analysis identified age (Odds ratio [OR] 1.05, 95% confidence interval [CI]: 1.010–1.092, p = 0.014), platelet (OR: 0.99, 95%CI: 0.980–0.998, p = 0.013), and WFA(+)-M2BP level (OR: 1.97, 95% CI: 1.299–2.984, p = 0.001) as independent factors associated with advanced fibrosis. Combination of age, platelet and WFA(+)-M2BP level achieved a better diagnostic performance for advanced fibrosis (AUROC: 0.732, accuracy: 81.3%) than APRI (AUROC: 0.577, accuracy: 63.8%) or FIB-4 index (AUROC: 0.691, accuracy: 75.6%). CONCLUSION: WFA(+)-M2BP had a good performance indistinguishing liver fibrosis in CHB patients. The combination of age, platelet, and WFA(+)-M2BPaddressed more accuracy in identifying patients with advanced fibrosis.