MicroRNAs as Diagnostic Biomarkers for Liver Fibrosis in Chronic Hepatitis B: Insights from Expression Profiling and Correlations with Fibrosis Stages

Chronic hepatitis B (CHB) infection remains a significant global health challenge, leading to severe liver complications such as cirrhosis and hepatocellular carcinoma (HCC), which makes accurate fibrosis assessment crucial for prognosis and treatment. This study investigated the expression levels of five miRNAs (hsa-miR-21-3p, hsa-miR-29a-3p, hsa-miR-122-3p, hsa-miR-221-3p, and hsa-miR-222-3p) in 40 CHB patients classified into mild-to-moderate (F1-F2) and severe fibrosis (F3-F4) groups using transient elastography. Quantitative PCR analysis revealed that hsa-miR-29a-3p ($$r=0.72$$, $$p<0.001$$), was upregulated, while hsa-miR-21-3p ($$r=-0.65$$, $$p<0.01$$) and hsa-miR-122-3p ($$r=-0.68$$, $$p<0.01$$,) were downregulated in severe fibrosis. Combining hsa-miR-29a-3p (AUC=0.89, 95% CI: 0.84–0.94) and hsa-miR-21-3p (AUC=0.87, 95% CI: 0.82–0.93) in a predictive model improved diagnostic accuracy. These findings highlight the potential of miRNA profiling to enhance current diagnostic algorithms. Further studies in larger cohorts are needed to validate their role in fibrosis assessment and disease monitoring.