Hyaluronic acid in the evaluation of liver fibrosis in patients with hepatitis C on haemodialysis

Background: This study evaluated the role of HA as a marker of liver fibrosis in patients with hepatitis C on haemodialysis. Methods: This is a cross-sectional study in which 52 patients were divided into two groups: Group 1: patients with hepatitis C and end-stage renal disease (ESRD) undergoing haemodialysis (n = 23); and Group 2: patients with hepatitis C without ESRD (n = 29). Plasma levels of HA were associated with histological data of the samples obtained by liver biopsy and classified by METAVIR group scoring system. Results: Higher plasma levels were significantly correlated to significant liver fibrosis (METAVIR ≥ F2). In Group 1, the HA cutoff to discriminate significant fibrosis was 984.8 ng/mL, with accuracy, sensitivity and specificity of 80.8%, 83.0%, and 70.0%, respectively. In Group 2, the HA cutoff was 222.3 ng/mL, with accuracy, sensitivity and specificity of 74.5%, 70.0%, and 94.0%, respectively. Conclusion: HA was an accurate noninvasive marker in predicting significant fibrosis in patients with hepatitis C on haemodialysis. Keywords: liver fibrosis, hyaluronic acid, end-stage renal disease, haemodialysis, hepatitis C