CRP Levels in Viral Hepatitis: A Meta-Analysis Study

Abstract

Context: Viral hepatitis is a common infectious disorder with a high degree of mortality. The host immunological feedback to the hepatitis virus is dim and unable to down-regulate and clear infection. C-reactive protein (CRP), an acute phase reactant synthesized by hepatocytes in response to inflammatory reactions, facilitates apoptosis and phagocytosis. An effort has been made in the current meta-analysis study to elucidate the relationship between CRP and hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. Methods: Eighteen published research articles on CRP levels of viral hepatitis patients were included in this study. A random-effects model was used to calculate the pooled mean level for CRP. Results: The pooled mean level of CRP hepatitis B and hepatitis C was 6.93 mg/L (95% CI: 3.04 - 10.81) and 2.31 mg/L (95% CI: 1.06 - 3.55), respectively. A high degree of variance was observed among the studies, with the I2 more than 90%. Conclusions: The pooled mean level of CRP was within the normal range in patients with hepatitis C; however, it was high in patients with hepatitis B. The pooled mean CRP level reported in this study can be useful to determine the level of liver damage in patients with viral hepatitis.

Diagnostic Potential of Inflammatory Biomarker Levels in the Serum of Patients with Hepatitis B Infection: A Retrospective Study

“…For instance, Moura et al (2019) suggested that hepatitis viral replication inhibits CRP production and is unrelated to HBsAg positivity (Zhiping et al, 2020). However, several studies have demonstrated elevated CRP and PCT levels in various liver diseases, such as hepatitis, liver carcinoma, and liver cirrhosis (Bhuiyan et al, 2019;Zheng et al, 2018;Igna et al, 2022;Yuan et al, 2013;Tan et al, 2018;Singh et al, 2021;Kang et al, 2021;Chen et al, 2020;Lu et al, 2021). Thus, our findings are consistent with the findings of studies supporting a significant association between inflammatory markers and hepatitis B.…”

Inflammatory Dysfunction in Hepatitis B-Positive Individuals: Quantitative Assessment of C-reactive protein (CRP) and Procalcitonin (PCT) Levels Using Immunofluorescence Assay

“…However, it is important to note that this study does not provide insights into the underlying reasons for these sex differences. Further research is needed to explore the mechanisms contributing to the observed sexspecific variations in CRP and PCT levels in the context of HBV infection [21] [22].…”

C-Reactive Protein: Pathophysiology, Diagnosis, False Test Results and a Novel Diagnostic Algorithm for Clinicians

“…Old data have shown that CRP seems to be undetected in hepatitis C, and recent evidence has demonstrated that the pooled mean CRP level was within the normal range in cases with hepatitis C; however, it was higher in hepatitis B cases, suggesting that CRP expression correlates with hepatitis B disease progression, but not in chronic hepatitis C, and there is also a possibility that cytokine-mediated response is more pronounced in chronic hepatitis B compared to chronic hepatitis C [ 938 , 939 , 940 ]. Yet, it was previously reported that anti-CRP autoantibodies have been reported in hepatitis C cases, a fact that raises further diagnostic questions for its lower levels in that condition.…”