Z Gastroenterol 2010; 48 - A60
DOI: 10.1055/s-0030-1254798

Fibrosis markers (serum hyaluronic acid, procollagen-III-peptide, pasma transforming growth factor-beta) and transient elastography (fibroscan) in chronic HCV infection

G Pár 1, A Vincze 1, T Berki 2, A Miseta 3, L Pajor 4, L Kereskai 4, Z Szereday 5, A Nagy 1, B Hunyady 1, A Pár 1
  • 11-st Department of Medicine, University of Pécs
  • 2Institute of Immunology and Biotechology, University of Pécs
  • 3Laboratory Medicine Institute, University of Pécs
  • 4Institute of Pathology, University of Pécs, Pécs
  • 5Baranya County Hospital, Pécs, Hungary

Background: Even mild chronic hepatitis C may be associated with severe fibrosis, that needed peg-interferon + ribavirin (P/R) therapy. We have tudied fibrosis markers and transient elastography (TE)(FibroScan) to assess liver fibrosis by these non-invasive tools. Patients and Methods: 119 HCV-patients (51 male, 68 female) have been enrolled, of them 75 had biopsy-proven chronic hepatitis C, 49 treated with P/R, 20 patients had cirrhosis, 20 individuals were symptomfree HCV-carriers with persistently normal alanine aminotransferase (PNA), 25 blood donors served as controls. Serum HCV-RNA has been determined by PCR, transforming growth factor (TGF) and hyaluronic acid (HA) by ELISA, procollagen-III-peptide (P-III-P) by RIA. Histological activity index (HAI) and fibrosis METAVIR score were studied in liver biopsy, for TE FibroScan was applied. Results: In hepatitis C patients all fibrosis markers were significantly elevated compared with controls (TGF: 14.21±1.62 vs. 9.95±1.66 pg/ml, HA: 149.1±24.3 vs. 19.03±3.99ng/ml, P-III-P: 1.41±0.43 vs. 0.71±0.05 U/ml). TGF was significantly higher in hepatitis C patients than in symptomfree HCV-carriers. High P-III-P values occurred only in advanced fibrosis. TGF correlated with HAI, HA with fibrosis score. After 3–6 months P/R therapy, both HA and TGF levels significantly decreased even in virological non-responders. LT values were as follows: controls: 5.10±1.19 kP, HCV-carriers with PNA: 5.38±1.37 kP, chronic hepatitis C (before treatment): 9.67±4.11 kP, patients with sustained virological response: 6.56±2.61 kP, non-responders 18.55±11.65 kP, HCV-cirrhosis patients: 37.40±16.85 kP. Conclusion: Both fibrosis markers and TE represent an advance in the non-invasive diagnosis of fibrosis. P/R treatment may inhibit fibrosis progression even independently of virological response in HCV infection. The work was supported by a grant from the National Research Fund (OTKA K81454 and Bolyai BO/00466/06).