Correlation between Serum Hyaluronic Acid with Steatosis, Non alcoholic Steato-hepatitis and Fibrosis in Patients with Chronic Hepatitis C Virus Infection

Abstract

Background: Hyaluronic acid (HA) is an attractive potential marker for noninvasive diagnosis of liver fibrosis instead of liver biopsy for both patients and physicians. Aim: To assess the role of HA for diagnosing the progression of steatosis to steato-hepatitis (SH) and fibrosis in patients with Chronic Hepatitis C virus (HCV) infection. Methods: 90 patients with chronic HCV infection, 77 (85.6%) males and 13 (14.4%) females, were included. Blood samples were collected for routine laboratory investigations, liver function tests and serum HA measurements. A liver biopsy was taken for histopathological examination. Results: Steatosis was found in 37 patients (41.1%), fibrosis in 29 patients (32.2%) and SH in 51 patients (56.7%). The mean serum HA for all patients was 86.4±48.2 ng/L. HA levels were significantly higher in patients with fibrosis (95.6±53 vs 54.5±3.5) and SH (88.7±52 vs 49.9±12) than those without (P value = 0.001and 0.001 respectively). HA levels were also significantly higher in patients with an advanced degree of fibrosis, SH and steatosis as compared to those with mild degrees (P value = 0.000, 0.001 and 0.01 respectively). Positive correlations were found between serum HA and the degree of fibrosis, SH and steatosis (P value =0.000 and r = + 0.758, 0.701and 0.727 respectively). The mean HA cut off value for the diagnosis of fibrosis and SH was taken to be 70 and 60 ng/L providing a diagnostic accuracy of 94.1% and 91.6% respectively. Conclusions: Serum HA level is a good noninvasive marker for the diagnosis of fibrosis and steato-hepatitis in patients with chronic HCV infection.

Metabolic syndromes, hepatitis B virus (HBV), and hepatitis C virus as three factors involved in the development of hepatic steatosis: a systematic review and meta-analysis

“…The data of 24 studies such as first author, year, country, number of hepatic steatosis patients, age and gender distribution, number of hepatic steatosis patients with viral hepatitis infection, risk of viral hepatitis in hepatic steatosis, and reference number are listed in Table 1[17–40]. For assessing the quality of eligible studies, the Newcastle-Ottawa Scale checklist was used.…”