title: Serum hyaluronate as a non-invasive marker of hepatic fibrosis and inflammation in HBeAg-negative chronic hepatitis B.
abstract: BACKGROUND
  HBV infection is a serious global heath problem. It is crucial to monitor this disease more closely with a non-invasive marker in clinical trials. We aimed to evaluate the predictive value of serum hyaluronate for the presence of extensive liver fibrosis and inflammation.
  
  
  METHODS
  28 healthy volunteers and 65 patients with HBeAg negative chronic hepatitis B were enrolled. Liver biopsies scored according to Ishak system. Association of serum hyaloronate with liver fibrosis and inflammation were assessed, and cut off points for serum hyaluronate levels were identified by receiver operating characteristics (ROC) curves and their values for prediction of fibrosis and inflammation were assessed.
  
  
  RESULTS
  In patients with CHB serum hyaluronate had the most significant correlation and predictive values for the liver fibrosis and inflammation comparing to the other variables. At the cut off point of 126.4 ngm/ml it could discriminate extensive fibrosis from milder ones with sensitivity of 90.9% and specificity of 98.1%. With the same value it could discriminate extensive inflammation from their milder counterparts with sensitivity of 63.6% and specificity of 92.6%.
  
  
  CONCLUSIONS
  Serum hyaluronate was the best predictor of extensive liver fibrosis and inflammation and it could discriminate subgroups of patients with chronic hepatitis B. It could be used as a non-invasive test to monitor these patients more closely with developing anti viral agents in clinical trials.
authors.affiliation: Digestive Disease Research Centre, Tehran University of Medical Science, Tehran, Iran. montazer@ams.ac.ir
authors.forename: Ghodrat
authors.initials: G
authors.lastname: Montazeri
authors.forename: Arezoo
authors.initials: A
authors.lastname: Estakhri
authors.forename: Mehdi
authors.initials: M
authors.lastname: Mohamadnejad
authors.forename: Negin
authors.initials: N
authors.lastname: Nouri
authors.forename: Farhad
authors.initials: F
authors.lastname: Montazeri
authors.forename: Ashraf
authors.initials: A
authors.lastname: Mohammadkani
authors.forename: Mohammad Hossain
authors.initials: MH
authors.lastname: Derakhshan
authors.forename: Farhad
authors.initials: F
authors.lastname: Zamani
authors.forename: Shahram
authors.initials: S
authors.lastname: Samiee
authors.forename: Reza
authors.initials: R
authors.lastname: Malekzadeh
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006513:Hepatitis B e Antigens / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000150:complications* / Q000276:immunology / Q000473:pathology; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood* / Q000473:pathology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D006513:Hepatitis B e Antigens; D006820:Hyaluronic Acid