Hyaluronic acid, tissue inhibitor of metalloproteinase-1 and aminoterminal peptide of procollagen type III related to liver damage in patients with hepatitis C virus (HCV) infection

VALVA P; CASCIATO P; DIAZ CARRASCO JM; GADANO A; GALOPPO MC; MULLEN E; DE MATTEO E; PRECIADO MV

Niza

Workshop; EASL Monothematic Conference on Evaluation of Disease Severity and Prognosis in Chronic Liver Disease.; 2011

Evaluation of Disease Severity and Prognosis in Chronic Liver Disease.

HCV hepatitis can progress to cirrhosis and/or HCC. Liver biopsy represents the gold standard for damage evaluation, but noninvasive tests to assess initial disease and progression are actual goals. Aim: to determine specific serum markers that correlate with liver injury during chronic HCV. Liver biopsies and concomitant serum samples from 22 HCV pediatric [median: 8 ys (1-17)] and 21 adult [median: 51 ys (28-74)] patients were analyzed. Histological parameters were evaluated. On serum hyaluronic acid (HA), tissue inhibitor of matrix metalloprotein inhibitor-1 (TIMP-1) and aminoterminal peptide of procollagen type III (PIIINP) were evaluated. Healthy subjects were included. Children showed 79% moderate/severe hepatitis, 46% bridging fibrosis and one cirrhosis. Adults showed 76% moderate/severe hepatitis and fibrosis 5% stage (st) 0, 38% st1, 33% st2 and 24% st3. 42% pediatric and 81% adult specimens showed lymphoid follicles. Both showed steatosis [62% children (37% minimal, 12.5% moderate and 12.5% severe), 53% adults (29%, 10% and 14% respectively)]. No histological differences were observed among groups, except for lymphoid follicles (p= 0.01). TIMP-1 and PIIINP were higher in HCV+ vs. control in both groups (p lower than 0.004). HA was higher in HCV+ vs control, but only significant in adults (p= 0.001). HA and TIMP-1 were higher in severe fibrosis, but only significant in adults (p= 0.001) and TIMP-1 in children (p= 0.04). PIIINP was higher in adults with severe fibrosis (p= 0.004). Interestingly, uppermost pediatric values of HA (239.6 ng/ml) and TIMP-1 (791.2 ng/ml) matched cirrhosis. Concerning hepatitis, HA and TIMP-1 showed a similar profile in both groups but were significantly elevated in children with severe hepatitis (p=0.001). Our results demonstrated that liver damage was of the same extent in adults and children. HA and PIIINP could be fibrosis progression markers in adults and TIMP-1 in children. HA and TIMP-1 might be hepatitis severity markers in children.