Assessment of liver fibrosis development in chronic hepatitis B patients by serum hyaluronic acid and laminin levels.

The aim of this work was to determine serum cut-off levels of hyaluronic acid (HA) and laminin (LN) as predicting factors for liver necro-inflammatory injuries, highlighting their diagnostic and therapeutic follow up value in chronic hepatitis B patients. Serum HA and LN were measured in chronic hepatitis B patients (n=35) by ELISA and compared with control group (n=20). Liver histopathologic parameters were evaluated according to the modified Knodell score. The mean serum HA and LN concentrations in patients (108.4 +/- 58.7 and 95.0 +/- 20.1 ng/mL, respectively) were greater than those in controls (46.6 +/- 10.6 and 46.1 +/- 10.2 ng/mL, respectively; P<0.001). Serum levels of HA and LN in all stages and grades of hepatic fibrosis and inflammation were significantly higher than those in the control group of healthy subjects (P<0.05). Cut-off levels of 52.0 ng/mL HA and 64.0 ng/mL LN in serum for discrimination of patients with liver fibrosis from those without liver fibrosis showed acceptable AUC, sensitivity and specificity. After 6 months of treatment, a decrease was observed in serum HA and LN levels; however, the levels were still higher than those in the control group (P<0.05). The correlation of fibrosis stages (not inflammation grades) with serum HA and LN levels was significant (P<0.01). The findings suggested the increase in serum HA and LN concentrations above the predictive values (52.0 ng/mL HA and 64.0 ng/mL LN, respectively) to be associated with liver fibrosis. Therefore, serum HA and LN levels could be determined as an additional clinical tool for evaluation of liver fibrosis, when liver biopsy is impossible to perform.