CLINICAL-SIGNIFICANCE OF SERUM HYALURONIC-ACID AS A FIBROSIS MARKER IN CHRONIC HEPATITIS-C PATIENTS TREATED WITH INTERFERON-ALPHA - HISTOLOGICAL-EVALUATION BY A MODIFIED HISTOLOGICAL ACTIVITY INDEX SCORING SYSTEM

The aim of the present study was to investigate the histological chang es effected by interferon (IFN) treatment and to evaluate the clinical significance of serum hyaluronic acid (HA) as a marker of fibrosis. F orty-nine patients with chronic hepatitis C treated with IFN-alpha wer e divided into three groups according to the existence of viraemia: su stained complete responders (CR), complete responders with relapse (PR ) and non-responders (NR). Needle biopsy sections of the liver taken b efore and at the end of IFN treatment were assessed according to the m odified histological activity index (HAI) scoring system. Serum fibros is markers, including HA, were measured at needle biopsies. Biopsies o f CR at the end of treatment showed a significant improvement in fibro sis and necroinflammatory scores. More significant correlation was obs erved between fibrosis scores and serum levels of HA before IFN treatm ent (r = 0.607, P < 0.0001) than those between fibrosis scores, on the one hand, and peptide of type III procollagen (PIIIP; r = 0.531, P = 0.0004) or type TV collagen 7S domain (type IV-C; r = 0.241, P = 0.106 2) on the other. Moreover, serum HA levels fell significantly in patie nts in whom fibrosis improved (P = 0.011). This is the first paper des cribing the advantages of the modified HAI scoring system over others in estimating the effect of IFN-alpha; the results also indicate that serum HA can be useful in monitoring liver fibrosis in chronic hepatit is C patients treated with IFN-alpha.