Abstract: Objective The aim of this study was to explore the probability to apply serum α1 acidic glycoprotein (AAG), α1-antitrypsin (AAT) and haptoglobin (HP) levels to diagnose the stages of liver fibrosis (LF) in patients with chronic hepatitis B (CHB). Methods 196 patients with CHB were recruited in our hospital between October 2017 and October 2019, and serum AAG, AAT and HP levels were detected by immunoturbidimetric method. All patients with CHB underwent liver biopsy. The diagnostic efficacy of serum AAG, AAT, HP levels and their combination for LF staging was assessed by the area under the receiver operating characteristic (ROC) curves (AUC). Results The pathological examination of liver tissues showed that in the 196 patients with CHB, there were 18 cases (9.2%) with liver fibrosis at S0 stage, 38 cases (19.4%) at S1 stage, and 140 cases (71.4%) at >S2 (significant LF); serum AAG and HP levels in patients with significant liver fibrosis were (0.5±0.2) g/L and (0.4±0.1) g/L, significantly lower than in patients with S1 or [(1.0±0.3) g/L and (1.3±0.4) g/L, P<0.05] in patients with S0, while serum AAT level was (59.7±7.2) μmol/L, significantly higher than in patients with S1 or in patients with S0; the ROC curves analysis showed that the cut-off values of serum AAG, AAT and HP in the diagnosis of significant liver fibrosis were 0.6 g/L, 50.2 μmol/L and 0.5 g/L, respectively, with the AUC of serum AAG, AAT and HP combination was 0.844 (0.769-0.902), significantly higher than that of AAG, AAT and HP alone , which had not significant difference compared with that of fibrosis 4 score (FIB-4) or aspartate aminotransferase to platelet index (APRI) . Conclusion The combination of serum AAG, AAT and HP levels shows a promising prospect in the diagnosis of significant LF in patients with CHB, which is worthy of further investigation.

Key words: Hepatitis B, Liver fibrosis, α1-acidic glycoprotein, α1-antitrypsin, Haptoglobin, Diagnosis