Serum pro-collagen III peptide levels are related to lobular necrosis in untreated patients with chronic hepatitis C

Objective Liver biopsy is mandatory for correctly grading and staging chron ic hepatitis activity. Nevertheless, serum markers of fibrogenesis may be u seful to help us understand the mechanisms of the fibrogenic process, to fo llow-up patients, and to establish the efficacy of therapy. In this study, our aim was to identify the relationships between pro-collagen III peptide (PIIIP) serum levels and detailed liver histology in a group of untreated p atients with chronic hepatitis C (CHC). Methods We studied 147 CHC patients. Correlation analysis of PIIIP serum le vels was performed in 109 patients, after having excluded those with alcoho l abuse or concomitant hepatitis B virus infection. PIIIP serum levels were assessed using an assay that measures both Col 1-3 peptide (reflecting col lagen synthesis) and Col 1 peptide (reflecting collagen degradation). Relat ionships of serum PIIIP with histology was carried out by evaluating gradin g and staging separately. Moreover, each component of the necro-inflammator y score was also taken into consideration. Results PIIIP levels were abnormal in 101 patients (93%). Moreover, PIIIP l evels were no different between patients with (12.1 +/- 6.3 ng/ml) or witho ut (13 +/- 5.8 ng/ml) fibrosis. In univariate analysis, no relationship was observed with fibrosis (r(s) = 0.033, not significant), while PIIIP levels were significantly correlated with lobular necrosis only (r(s) = 0.295, P = 0.0020). Multivariate analysis confirmed this latter finding (P = 0.0150) . Among biochemical parameters, PIIIP showed relationships with aminotransf erase (AST, r(s) = 0.294, P = 0.0022; ALT, r(s) = 0.236, P = 0.0142) and al kaline phosphatase (r(s) = 0.146, P = 0.0223). Conclusions In patients with CHC, serum PIIIP levels reflect histological p arameters strictly related to fibrogenesis, Therefore, PIIIP is a useful to ol to evaluate ongoing fibrogenic activity of CHC. A complete histological score is needed in order to understand the relationships between biochemica l markers of fibrogenesis and histology. Eur J Gastroenterol Hepatol 13:137 -141 (C) 2001 Lippincott Williams & Wilkins.