Abstract
The aim of our study is to determine the changes in the biomarkers CXCL-16, CCL-20, GDF-15, and CD8a, which play an immunological role in CHB patients according to viral load to determine their diagnostic potential and to investigate their relationships with hematological parameters and non-invasive fibrosis indices. Our study included 96 chronic hepatitis B patients and 30 healthy individuals as a control group. The patients were divided into three groups based on their serum HBV DNA levels: mild (0-10(2) IU/mL), moderate (10(3)-10(5) IU/mL), and severe viral load (10(6)-10(8) IU/mL). HBV DNA levels were determined by the real-time PCR (Anatolia, Istanbul, Turkey) method. CXCL-16, GDF-15, and CD8a levels in patient serum were quantitatively determined by the ELISA method (Elabscience, Wuhan, China), and CCL-20 levels were determined by the ELISA method BT LAB, Shanghai, China). ROC (Receiver Operating Characteristics) and HUM (Hypervolume Under Manifold) analyses were used to determine the diagnostic efficacy of the biomarkers. ROC analyses showed that GDF-15 (AUC = 0.920) and CCL-20 (AUC = 0.751) had "very good" and "good" diagnostic values, respectively, in predicting hepatitis B disease. HUM analyses revealed that all biomarkers have good potential when it comes to distinguishing the severity of the disease. This study has shown that the biomarkers GDF-15 and CCL-20 may be potential diagnostic biomarkers in detecting the presence of chronic hepatitis B, and the biomarkers CXCL-16, CCL-20, GDF-15, and CD8a may be potential diagnostic biomarkers in determining the severity of the disease. These findings suggest that these biomarkers, which can be measured by the simpler and more economical ELISA method, could be a supportive tool for the HBV DNA test. The clinical use of these biomarkers can be expanded with future prospective studies.