Abstract: Objective To investigate the relationship between serum C-C motif chemokine ligand 5 (CCL-5) and liver fibrosis in patients with chronic hepatitis B (CHB). Methods A total of 180 CHB patients diagnosed and treated in Jinjiang City Hospital from June 2022 to June 2024 and 70 healthy volunteers served as the control group were enrolled in this study. The CHB patients were divided into a non-significant liver fibrosis group (n=112) and a significant liver fibrosis group (n=68) based on the modified Scheuer scoring system. The general data [age, sex, body mass index, comorbidities (e.g., hypertension, diabetes, hyperlipidemia), CHB duration (only CHB patients)], liver ultrasound findings [e.g., intrahepatic nodules, diameter of the left/middle/right hepatic veins, liver stiffness measurement (LSM), portal vein flow velocity], and laboratory parameters [hepatitis B virus DNA (HBV DNA), hepatitis B surface antigen (HBsAg), alanine aminotransferase (ALT), aspartate aminotransferase (AST), platelet count, international normalized ratio (INR), CCL-5] were collected and compared within the groups. Indicators with statistical significance in univariate analysis between the two CHB groups were included in multivariate Logistic regression analysis. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of relevant indicators for significant liver fibrosis in CHB patients. Results No significant differences were observed among the three groups in sex, body mass index, portal vein flow velocity, ALT, AST and INR (P＞0.05). Between the 2 CHB groups, no significant differences were found in comorbidities, CHB duration and intrahepatic nodules (P＞0.05). Compared with the control group, both CHB groups showed significantly reduced diameters of the left/middle/right hepatic veins and platelet counts (P＜0.05), whereas the LSM and CCL-5 levels were significantly elevated (P＜0.05). Compared with the non-significant fibrosis group, the significant liver fibrosis group showed significantly reduced diameters of the left [(6.62±2.02) mm vs. (5.32±1.52) mm]/middle [(6.79±2.11) mm vs. (5.53±1.60) mm]/right hepatic veins[(7.55±1.97) mm vs. (5.46±1.38) mm] and platelet counts [(193.26±46.64) ×10⁹/L vs. (171.65±33.57) ×10⁹/L] (P＜0.05), whereas the LSM, HBV DNA, HBsAg, and CCL-5 levels were significantly elevated (P＜0.05), and the age [(6.8±2.1)y vs. (58.5±9.9) y]), LSM [(8.91±2.41) kPa vs. (1.79±2.65) kPa], HBV DNA [(4.09±1.11) IU/mL vs. (4.62±1.30) IU/mL], HBsAg [(3.20±0.69) lg U/mL vs. (4.16±1.21) lg U/mL] and CCL-5 [(4.62±1.21) ng/mL vs. (5.53±1.60) ng/mL] were significantly higher (P＜0.05). By Logistic regression analysis it was identified that age [OR(95%CI: 1.204 (1.073~1.351)], LSM[OR(95%CI: 1.754 (1.281~2.402)] and CCL-5 [OR(95%CI: 14.737 (5.936~36.589)] as independent risk factors for significant liver fibrosis in CHB patients (P＜0.05). The optimal cutoff values for predicting significant fibrosis were: age ≥52 years, LSM ≥10.10 kPa and CCL-5 ≥3.58 ng/mL. The combination of these three indicators demonstrated a higher predictive efficacy [area under the curve (AUC) and sensitivity] than that of any single parameter. Conclusion Serum CCL-5 levels are significantly elevated in CHB patients with significant liver fibrosis. CCL-5 is an independent risk factor for liver fibrosis, and its combination with age and LSM significantly improves its diagnostic efficacy as a non-invasive marker for significant liver fibrosis in CHB patients.

Key words: Chronic hepatitis B, Chemokine, C-C motif chemokine ligand 5, Hepatic fibrosis