BACKGROUND Treatment response to direct-acting antivirals(DAAs)is a challenging issue and the identification of non-responders patients is very important.AIM To evaluate the relation between baseline serum levels of h...BACKGROUND Treatment response to direct-acting antivirals(DAAs)is a challenging issue and the identification of non-responders patients is very important.AIM To evaluate the relation between baseline serum levels of hyaluronic acid(HA)and type III procollagen N-peptide(PIIINP)with direct-acting antivirals treatment failure in Egyptian patients with chronic hepatitis C.METHODS Hepatitis C patients(responders and non-responders to sofosbuvir/daclatasvir)were tested for HA and PIIINP using sensitive chemiluminescent immunoassay.RESULTS There were distinctly higher PIIINP(P=0.0003)and HA(P<0.0001)levels in non-responders than responders patients with a good ability for distinguishing non-responders from patients with sustained virological response(area under the curve=0.766 for HA and 0.684 for PIIINP).Logistic regression analysis revealed that the HA×PIIINP is the model with the highest predictive ability(area under the curve=0.809).Diagnostic performances were superior to each marker alone with good sensitivity(74.7%),specificity(74%),positive predictive(68.3%),negative predictive values(79.6%)and accuracy(74.3%).The multiplication of HA×PIIINP is correlated significantly(P<0.05)with elevated liver enzymes(r=0.212),decreased albumin(r=-0.26),elevated aspartate aminotransferase-platelet ratio index(r=0.223)and elevated fibrosis-4 score(r=0.216)scores.CONCLUSION These findings suggested the remarkable role of fibrogensis markers HA and PIIINP in the prediction of hepatitis C virus DAAs treatment response.Multiplying HA with PIIINP values increase the sensitivity to detect treatment success and thus may aim to improve treatment duration and the disease control.展开更多
文摘BACKGROUND Treatment response to direct-acting antivirals(DAAs)is a challenging issue and the identification of non-responders patients is very important.AIM To evaluate the relation between baseline serum levels of hyaluronic acid(HA)and type III procollagen N-peptide(PIIINP)with direct-acting antivirals treatment failure in Egyptian patients with chronic hepatitis C.METHODS Hepatitis C patients(responders and non-responders to sofosbuvir/daclatasvir)were tested for HA and PIIINP using sensitive chemiluminescent immunoassay.RESULTS There were distinctly higher PIIINP(P=0.0003)and HA(P<0.0001)levels in non-responders than responders patients with a good ability for distinguishing non-responders from patients with sustained virological response(area under the curve=0.766 for HA and 0.684 for PIIINP).Logistic regression analysis revealed that the HA×PIIINP is the model with the highest predictive ability(area under the curve=0.809).Diagnostic performances were superior to each marker alone with good sensitivity(74.7%),specificity(74%),positive predictive(68.3%),negative predictive values(79.6%)and accuracy(74.3%).The multiplication of HA×PIIINP is correlated significantly(P<0.05)with elevated liver enzymes(r=0.212),decreased albumin(r=-0.26),elevated aspartate aminotransferase-platelet ratio index(r=0.223)and elevated fibrosis-4 score(r=0.216)scores.CONCLUSION These findings suggested the remarkable role of fibrogensis markers HA and PIIINP in the prediction of hepatitis C virus DAAs treatment response.Multiplying HA with PIIINP values increase the sensitivity to detect treatment success and thus may aim to improve treatment duration and the disease control.
