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Clin Mol Hepatol. 2019 Mar;25(1):42-51. English. Original Article.
Mölleken C , Ahrens M , Schlosser A , Dietz J , Eisenacher M , Meyer HE , Schmiegel W , Holmskov U , Sarrazin C , Sorensen GL , Sitek B , Bracht T .
Department of Gastroenterology and Hepatology, University Hospital Bergmannsheil, Bochum, Germany.
Medizinisches Proteom-Center, Ruhr University Bochum, Bochum, Germany.
Chrestos Concept GmbH & Co. KG, Essen, Germany.
Institute for Molecular Medicine, University of Southern Denmark, Odense, Denmark.
Medical Clinic 1, J.W. Goethe University Hospital, Frankfurt, Germany.
Leibniz-Institut für Analytische Wissenschaften – ISAS - e.V., Dortmund, Germany.
Medical Clinic 2, St. Josefs-Hospital, Wiesbaden, Germany.


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.


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.


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).


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.

Copyright © 2019. Korean Association of Medical Journal Editors.