SERUM HYALURONIC-ACID AND LAMININ IN CHILDREN WITH CHRONIC HEPATITIS-B

Objective: To evaluate whether hyaluronic acid and laminin P1 serum co ncentrations reflect the presence of liver fibrosis and/or cirrhosis i n children with chronic hepatitis B infection. Design and patients: Se rum concentrations of hyaluronic acid and laminin P1 were correlated w ith several clinical, biochemical and histological parameters in 54 ch ildren (mean age, 7.7 years) with chronic hepatitis B, in 13 healthy c arriers, and in 18 age- and sex-matched controls. Results: Levels of h yaluronic acid in patients with cirrhosis were significantly higher th an in controls and patients without cirrhosis. Concentrations above 10 0 mug/l were observed only in children with cirrhosis, but sensitivity was low. Serum concentrations of laminin P1 in patients with cirrhosi s were significantly higher than in controls, but overlapped with valu es in the order patients subgroups. The extent of fibrosis, assessed b y computerized histomorphometry, correlated significantly with serum c oncentrations of both hyaluronic acid and laminin P1; no cut-off value discriminated between small and large lesions. The concentrations of hyaluronic acid and laminin P1 were highest in patients with marked ca pillarization of liver sinusoids at electron microscopy and/or thicken ed lesser omentum at sonography, two alleged features of portal hypert ension. Conclusions: The correlation between serum concentrations of h yaluronic acid and laminin P1 and the presence of liver fibrosis and/o r cirrhosis in children with chronic hepatitis B virus infection was s tatistically significant but clinically limited.