Multicenter evaluation of M2BPGi as a biomarker for liver fibrosis and hepatocellular carcinoma in chronic hepatitis B and C patients in Malaysia

BackgroundChronic hepatitis B (HBV) and C (HCV) cause major global morbidity, especially in settings with limited diagnostic access. Although liver biopsy is the gold standard for fibrosis assessment, it is unsuitable for large-scale screening. Mac-2 binding protein glycosylation isomer (M2BPGi) has emerged as a promising non-invasive biomarker for liver fibrosis and hepatocellular carcinoma (HCC), but data from Southeast Asia remain limited. This study assessed its diagnostic accuracy among chronic HBV and HCV patients in Malaysia.MethodsA cross-sectional study was conducted among 154 participants from seven Malaysian public hospitals: 62 HCV patients, 52 HBV patients, and 40 healthy controls. Liver stiffness was measured using transient elastography (FibroScan), and serum biomarkers (M2BPGi, AFP, FIB-4, GPR) were analyzed. Diagnostic performance for fibrosis, cirrhosis, and HCC was evaluated using ROC curve analysis.ResultsM2BPGi levels rose with increasing disease severity, with median values of 0.4 COI (controls), 0.8 COI (non-cirrhotic), 4.9 COI (cirrhotic), and 3.9 COI (HCC) (p