Micro RNAs as a potential biomarker for predicting liver fibrosis severity in hepatitis C virus affected patients.

Background: Hepatitis C virus (HCV) infection process of progression encompasses multiple stages, commencing with inflammation and culminating in hepatocellular cancer. Numerous invasive and non-invasive procedures exist for diagnosing chronic HCV infection. Though beneficial, invasive procedures can cause morbidity and inadequate representation of the overall degree of fibrosis. Due to these reasons, non-invasive liver fibrosis biomarkers are becoming more prevalent to diagnose and track liver fibrosis without a liver biopsy. These biomarkers can detect liver fibrosis early, improving treatment and preventing cirrhosis and liver failure. Micro ribonucleic acid (MiRNA) dysregulation causes and worsens several diseases including liver disease. MiRNAs can facilitate the diagnosis of liver fibrosis and serve as a predictive tool to enhance patient care by minimizing invasive procedures and enabling more efficient and prompt therapy.

Aim: To investigate the diagnostic effectiveness of several miRNAs (miRNA-122, miRNA-21, miRNA-199a, miRNA-155) in assessing the liver fibrosis severity in untreated HCV patients from the Indian Punjab population. We seek to identify the intricate diagnostic relationship of miRNAs with the extent of fibrosis among individuals with HCV.

Methods: We considered 100 persons determined as HCV infected by a quantitative Real-Time Polymerase Chain Reaction examination. We employed statistical as well as probabilistic tools to ascertain the diagnostic validity of miRNAs for determining the liver fibrosis stages. We employed Bayesian Networks, to introduce a unique diagnostic paradigm for miRNAs that can be adopted as benchmark to evaluate the liver fibrosis severity in HCV cases.

Results: We found that miRNAs (miR-122, miR-155 and miR-21) showed significant upregulation when compared with control and according to severity of fibrosis ( ≤ 0.05). The area under the curve for miR-122, miR-155, miR-21 and miR-199a in HCV group in relation to Liver Stiffness Measurement was calculated as 0.889, 0.933, 0.912 and 0.035 respectively. MiR-199a was downregulated according to degree of fibrosis.

Conclusion: Depending on the diagnostic accuracy, we have concluded that miR-122, miR-155 and miR-21 are reliable markers to detect fibrosis in Hepatitis C patients.