Serum hyaluronan as a marker of liver fibrosis in asymptomatic chronic viral hepatitis B

Increased concentrations of serum hyaluronan, a polysaccharide widely distr ibuted in the extracellular space, have been demonstrated in liver disease of various aetiologies and proposed as, a useful marker of liver fibrosis. The aim of the present study was to evaluate the association of serum hyalu ronan with the extent of hepatic fibrosis in asymptomatic cases of chronic hepatitis B viral infection. The study was conducted in a consecutive sampl e of 111 asymptomatic chronic carriers of hepatitis B surface antigen. Live r function tests, alcohol consumption and cigarette smoking were determined and, for 84 subjects, liver biopsy was performed and degrees of inflammati on and fibrosis were scored. Hyaluronan was measured using a radiometric as say. Mean serum hyaluronan increased with increasing fibrosis score (from 2 2.2 +/- 4.8 to 50.6 +/- 12.7 mu g/l, p = 0.058) or pathological severity (f rom 18.8 +/- 5.9 to 50.6 +/- 12.5 mu g/l, p = 0.048), even after adjusting for the effect of age. No such correlation was found with portal inflammati on. The study showed that, in asymptomatic chronic carriers of hepatitis B, serum hyaluronan concentration correlates with hepatic fibrosis, a known m arker of disease prognosis. This finding supports the hypothesis that hyalu ronan might be of use in assessing and monitoring time trends in liver dise ase, substituting for repeated biopsies.