Plasma TGF-beta, hyaluronic acid and procollagen-III-peptide levels as fibrosis markers in chronic hepatitis C

Aim: It is known that even mild chronic hepatitis C can be associated with severe fibrosis, that require antiviral treatment. As interferon (IFN) has antifibrotic effect, our aims were to study different fibrosis markers that would be useful for noninvasive follow-up of patients with chronic hepatitis C during IFN therapy.

Methods: Plasma levels of TGF-beta, hyaluronic acid (HA) and procollagen-III-peptide (P-III-P) have been measured by ELISA or RIA in 47 patients with chronic hepatitis C, in 18 responders previously treated with IFN, in 27 asymptomatic HCV carriers and in 30 healthy controls. The relationship between these markers, the histological activity (HAI) and the degree of fibrosis in liver biopsy has been evaluated.

Results: Plasma TFG-beta (15±1 pg/ml) and HA levels (107±14 ng/ml) significantly increased in chronic hepatitis C patients as compared to asymptomatic HCV carriers (TFG-b: 9,9±2 pg/ml, HA: 24±6 ng/ml) IFN-responders (TFG-b: 11,6±1 pg/ml, HA: 29,5±4 ng/ml) and controls (TFG-b: 9±1 pg/ml, HA: 19±4 ng/ml p<0,01). HA levels correlated with the degree of fibrosis, while TGF-b levels with the HAI (r=0,5). No correlation was noted between HA and TGF-b levels. P-III-P levels were highest in cirrhotic patients (1,5+/-0,4U/ml), but elevated also in mild (1,1±0,4 U/ml) or severe active hepatitis patients (1,3±0,5 U/ml) as compared to controls (0,7±0,1 U/ml).

Conclusion: Our data suggest that TGF-beta, hyaluronic acid and P-III-P can be useful for noninvasive follow-up of inflammatory acitvity and fibrosis. Nevertheless further studies may be warranted to evaluate the real usefulness of these markers in chronic hepatitis C.