Clin Mol Hepatol.  2019 Mar;25(1):42-51. 10.3350/cmh.2018.0029.

Direct-acting antivirals-based therapy decreases hepatic fibrosis serum biomarker microfibrillar-associated protein 4 in hepatitis C patients

• Mölleken
• Ahrens M
• Schlosser
• Dietz J
• Eisenacher M
• Meyer HE
• Schmiegel
• Holmskov U
• Sarrazin C
• Sorensen G
• Sitek B
• Bracht T

• KMID: 2447250
• DOI: http://doi.org/10.3350/cmh.2018.0029

Abstract

BACKGROUND/AIMS
An estimated 80 million people worldwide are infected with viremic hepatitis C virus (HCV). Even after eradication of HCV with direct acting antivirals (DAAs), hepatic fibrosis remains a risk factor for hepatocarcinogenesis. Recently, we confirmed the applicability of microfibrillar-associated protein 4 (MFAP4) as a serum biomarker for the assessment of hepatic fibrosis. The aim of the present study was to assess the usefulness of MFAP4 as a biomarker of liver fibrosis after HCV eliminating therapy with DAAs.
METHODS
MFAP4 was measured using an immunoassay in 50 hepatitis C patients at baseline (BL), the end-of-therapy (EoT), and the 12-week follow-up (FU) visit. Changes in MFAP4 from BL to FU and their association with laboratory parameters including alanine aminotransferase (ALT), aspartate aminotransferase (AST), platelets, the AST to platelet ratio index (APRI), fibrosis-4 score (FIB-4), and albumin were analyzed.
RESULTS
MFAP4 serum levels were representative of the severity of hepatic fibrosis at BL and correlated well with laboratory parameters, especially APRI (Spearman correlation, R²=0.80). Laboratory parameters decreased significantly from BL to EoT. MFAP4 serum levels were found to decrease from BL and EoT to FU with high statistical significance (Wilcoxon p<0.001 for both).
CONCLUSIONS
Our findings indicate that viral eradication resulted in reduced MFAP4 serum levels, presumably representing a decrease in hepatic fibrogenesis or fibrosis. Hence, MFAP4 may be a useful tool for risk assessment in hepatitis C patients with advanced fibrosis after eradication of the virus.

Keyword

Hepatitis C, Chronic; Biomarkers; Liver cirrhosis; Antiviral agents; Extracellular matrix proteins

MeSH Terms

Alanine Transaminase
Antiviral Agents
Aspartate Aminotransferases
Biomarkers
Blood Platelets
Extracellular Matrix Proteins
Fibrosis*
Follow-Up Studies
Hepacivirus
Hepatitis C*
Hepatitis C, Chronic
Hepatitis*
Humans
Immunoassay
Liver Cirrhosis
Risk Assessment
Risk Factors
Alanine Transaminase
Antiviral Agents
Aspartate Aminotransferases
Biomarkers
Extracellular Matrix Proteins