Accuracy of Hyaluronic Acid Level for Prediction of Liver Fibrosis Stages in Patients with Hepatitis C

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Accuracy of Hyaluronic Acid Level for Prediction of Liver Fibrosis Stages in Patients with Hepatitis C In patients with chronic hepatitis C virus, liver biopsy is the gold standard for assessing liver disease stage; nevertheless, it is prone to complications, some of them serious. Non-invasive methods have been proposed as surrogate markers for liver fibrosis.

It has been demonstrated that serum hyaluronic acid (HA) levels increase with the development of liver fibrosis. The aim of this study was to evaluate the diagnostic value of HA as well as to determine the HA level cut-off for predicting the presence or absence of fibrosis, severe fibrosis and cirrhosis.

Results

· 405 patients with chronic hepatitis C were prospectively included with biomarker measurement and liver biopsy done the same day: 151 in the training set (only biopsy lengths of 25 mm or more) and 254 in the validation set.

· For the discrimination of significant fibrosis, severe fibrosis and cirrhosis in the training set, the areas under curve (AUCs) were 0.75+/-0.03, 0.82+/-0.02, and 0.89+/-0.03, respectively.

· Absence of significant fibrosis, severe fibrosis and cirrhosis can be predicted by HA levels of 16, 25, and 50 ug/l, respectively (with negative predictive values of 82%, 89%, and 100%, in the same order).

· Presence of significant fibrosis, severe fibrosis and cirrhosis can be predicted by HA levels of 121, 160, and 237 ug/l, respectively (with positive predictive values of 94%, 100%, and 57%, in the same order).

Conclusion

Based on these findings, the authors conclude, “In the validation set, HA was accurate in predicting significant fibrosis, severe fibrosis, and cirrhosis with AUCs of 0.73, 0.77, and 0.97, respectively. Moreover, accurate HA level cut-offs were defined for predicting significant fibrosis, severe fibrosis, and cirrhosis.”

“Thus, the study supports that HA level may be clinically useful as a non-invasive marker for liver fibrosis and/or cirrhosis.”

07/20/05

ReferencePhilippe Halfon and others. Accuracy of hyaluronic acid level for predicting liver fibrosis stages in patients with hepatitis C virus. Comparative Hepatology 4(1):6 July 11, 2005 [Epub ahead of print

http://www.hivandhepatitis.com/hep_c/news/2005/ad/072005_b.html