ORIGINAL ARTICLE   

Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2025 January-February;184(1-2):16-21

DOI: 10.23736/S0393-3660.24.05530-X

Copyright © 2024 EDIZIONI MINERVA MEDICA

language: English

The role of tissue-type plasminogen activator in chronic hepatitis B-related liver cirrhosis

Fadli FADLI ¹ ✉, Sahyuddin SALEH ^{1, 2}, Muhammad L. PAREWANGI ^{1, 3}, Syakib BAKRI ^{1, 4}, Andi F. BENYAMIN ^{1, 2}, Arifin SEWENG ⁵

¹ Department of Internal Medicine, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia; ² Divison of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia; ³ Divison of Gastroenterohepatology, Department of Internal Medicine, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia; ⁴ Division of Renal Hypertension, Department of Internal Medicine, Universitas Hasanuddin, Makassar, Indonesia; ⁵ Department of Public Health and Community Medicine, Universitas Hasanuddin, Makassar, Indonesia

BACKGROUND: Hepatitis B is an important worldwide health matter that frequently leads to cirrhosis and liver cancer, resulting in substantial mortality. Cirrhosis complicates a considerable percentage of cases, causing impaired clotting and potential bleeding. Elevated tissue-type plasminogen activator (tPA) levels, essential in dissolving blood clots, are associated with severe liver conditions. This focused on tPA’s role in chronic hepatitis B patients with liver cirrhosis.
METHODS: The period of this prospective observational study was between April and August of 2023. Serum tissue-type plasminogen activators were evaluated in 70 chronic hepatitis B patients, 23 of whom had liver cirrhosis and 47 who did not, using the enzyme-linked immunosorbent assay (ELISA).
RESULTS: Compared to individuals without liver cirrhosis, patients with chronic hepatitis B had significantly higher serum tPA levels (P=0.00) and were significantly associated with Fibroscan (Echosens, Paris, France) degree at F4 level. In the multivariate regression study, Child-Turcotte-Pugh (CTP) Class, aspartate aminotransferase (AST), tPA, and serum albumin were independent indicators of risk for liver cirrhosis progression among chronic hepatitis B patients (OR=1.35, 95% CI: 1.09-1.67, P=0.00; OR=1.03, 95% CI: 1.00-1.07, P=0.02; OR=0.04, 95% CI: 0.00-0.87, P=0.04; OR=0.03, 95% CI: 0.00-0.46, P=0.01, accordingly).
CONCLUSIONS: According to our findings, blood tPA levels were shown to be higher in chronic hepatitis B virus (HBV) patients with liver cirrhosis, were linked with Fibroscan (Echosens) scores, and could be regarded as possible indicators of liver cirrhosis.

KEY WORDS: Tissue plasminogen activator; Hepatitis B, chronic; Liver cirrhosis