Measurement of serum hyaluronic acid in patients with chronic hepatitis C and its relationship to liver histology

John G. McHutchison, Larry M. Blatt, Maria De Medina, John R. Craig, Andrew Conrad, Eugene R. Schiff, Myron J. Tong

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214 Scopus citations


Background and Aims: Chronic hepatitis C is a slowly progressing inflammatory disease of the liver that can lead to cirrhosis and its complications. Assessment of liver damage in hepatitis C has been primarily via histological evaluation. Liver biopsy, while useful in determining the extent of liver damage, has associated costs and places patients at a small but finite risk of bleeding. Studies in small patient populations have identified serum markers shown to correlate with liver histology, including procollogen III peptide and hyaluronic acid (HA). To determine whether serum HA was a reliable predictor of cirrhosis and fibrosis, we examined serum HA concentrations from 486 chronic Hepatitis C virus (HCV) patients. Methods and Results: Patients were anti-HCV and HCV RNA positive, with elevated alanine aminotransferase values and underwent a liver biopsy. Sera were obtained at the baseline for HA using radioimmunoassay methodology. Patients with cirrhosis had significantly higher serum HA concentrations compared with non-cirrhotic patients (382 ± 31 vs 110 ± 9 μg/L respectively, P<0.001). Patients with fibrosis had significantly higher mean serum HA concentrations (179 ± 11 μg/L) compared with patients without fibrosis (62 ± 20 μg/L; P<0.001). The correlation between HA concentration and the components of the Knodell histological activity index score revealed no strong associations with the exception of fibrosis, which showed moderate correlation (R=0.5421, P<0.001). The clinical value of HA measurement appears to be its ability to exclude cirrhosis. A HA value of <60 μg/L excluded the presence of cirrhosis or significant fibrosis with a predictive value of 99 and 93%, respectively. Conclusions: Serum HA measurement may be clinically useful to non-invasively assess the degree of fibrosis and cirrhosis. Further prospective studies are warranted to determine the clinical utility of HA as a non-invasive marker of liver fibrosis. (C) 2000 Blackwell Science Asia Pty Ltd.

Original languageEnglish (US)
Pages (from-to)945-951
Number of pages7
JournalJournal of Gastroenterology and Hepatology (Australia)
Issue number8
StatePublished - Jan 1 2000
Externally publishedYes


  • Chronic hepatitis C virus
  • Fibrosis
  • Hyaluronic acid

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology


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