Serum hyaluronic acid during lamivudine treatment in chronic hepatitis B
Grzeszczuk A, Prokopowicz D

Purpose: We address the question whether lamivudine treatment modulates serum concentrations of hyaluronic acid and whether the pre-treatment HA level can give the information about the presumptive result of treatment and whether HA level evaluation can be useful in monitoring the antiviral therapy in chronic hepatitis B.
Material and methods: Forty-nine patients, 31 man, aged 40±2.5 years were treated with 100 mg lamivudnie per day for 48 weeks. Serum hyaluronic acid level was determined using enzyme-linked binding protein commercial assay (Corgenix Inc., USA).
Results: The mean HA pre-treatment levels were higher than among controls (69.6±11.6 ng/ml vs 36.5±7.6 ng/ml, mean ±SEM) and correlated with AST activity, p=0.002; GGT activity, p=0.006; ALP activity p<0.001; prothrombin time, p=0.01; and peripheral blood platelets count, p=0.001 but did not correlated with ALT activity. The pre-treatment HA concentration correlated also with interlobular necroinflammatory activity score, p=0.049 and with fibrosis score, p=0.026, according to Scheuer classification. The mean HA levels decreased gradually during lamivudine treatment, up to levels lover than among controls (26.3±5.7 ng/ml). There were not significant differences in pre-treatment levels observed between patients neither with HBs seroconversion versus those without it, nor between patients with HBe seroconversion versus those without it and among patients with normalization of ALT activity versus ones without it.
Conclusions: Serum hyaluronic acid level decreases during lamivudine treatment both in patients with HBeAg seroconversion and without it; serum hyaluronic acid pre-therapy levels correlate with necroinflammatory lobular activity score and with liver fibrosis score; serum hyaluronic acid is of no predictive value for lamivudine therapy response; serum hyaluronan may be valuable complementary marker in chronically HBV infected patients.

Key words:   hyaluronan, chronic hepatitis B, lamivudine.