title: Serum hyaluronan and collagen IV as non-invasive markers of liver fibrosis in patients from an endemic area for schistosomiasis mansoni: a field-based study in Brazil.
abstract: Non-invasive markers of fibrosis have been used to diagnose liver fibrosis in a variety of diseases. Hyaluronic acid (HA) and collagen IV (C-IV) levels were measured in the sera of patients from an endemic area for schistosomiasis in Brazil to diagnose and to rank the intensity of liver fibrosis. Seventy-nine adult patients with schistosomiasis, in the age range of 21-82 years (49 +/- 13.4) were submitted to clinical and ultrasonographic examinations. Ultrasound was employed to diagnose and categorise liver fibrosis according to World Health Organization patterns. Serum HA and C-IV levels were measured using commercial ELISA kits. Ultrasound revealed six patients with intense liver fibrosis, 21 with moderate, 23 with light and 29 without. Serum HA was able to separate individuals with fibrosis from those without (p < 0.001) and light from intense fibrosis (p = 0.029), but C-IV was not (p = 0.692). The HA diagnostic accuracy for fibrosis was 0.89. The 115.4 ng/mL cut-off level diagnosed patients with fibrosis (sensitivity 0.98, specificity 0.64). HA correlated positively with portal hypertension. Periportal fibrosis (subjective evaluation), age and collateral circulation predicted HA increase. In conclusion, we propose that serum HA can be used to identify patients with liver fibrosis in an endemic area for schistosomiasis mansoni in Brazil.
authors: Programa de Pós-Graduação em Ciências da Saúde, Infectologia e Medicina Tropical, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil. carolinacmarinho@gmail.com
authors: Carolina Coimbra
authors: CC
authors: Marinho
authors: Thales
authors: T
authors: Bretas
authors: Izabela
authors: I
authors: Voieta
authors: Leonardo Campos de
authors: LC
authors: Queiroz
authors: Raiza
authors: R
authors: Ruiz-Guevara
authors: Antônio Lúcio
authors: AL
authors: Teixeira
authors: Carlos Maurício
authors: CM
authors: Antunes
authors: Aluízio
authors: A
authors: Prata
authors: José Roberto
authors: JR
authors: Lambertucci
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D024141:Collagen Type IV / Q000097:blood*; D003430:Cross-Sectional Studies; D019353:Endemic Diseases; D058501:Enzyme-Linked Immunospot Assay; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012555:Schistosomiasis mansoni / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D015415:Biomarkers; D024141:Collagen Type IV; D006820:Hyaluronic Acid