Serum hyaluronan and laminin level in children with chronic hepatitis B during long-term lamivudine treatment.

Background/aims: The aim was to assess the effect of long-term lamivudine treatment on liver fibrosis by direct assessment of histological scores and by indirect assessment of serum biomarkers in children with chronic hepatitis B (chB).

Methodology: The observation was carried out on 31 children with biopsy proven chB who were nonresponders to previous IFNalpha therapy. The serum concentration of hyaluronan and laminin were measured before and up to 24 months of therapy. ROC analysis was used to calculate the power of the assays to detect advanced liver fibrosis (score > 2 according to Batts & Ludwig).

Results: Serum hyaluronan and laminin level were significantly higher in children with chB compared to controls. There was a significant correlation between serum hyaluronan level and the stage of liver fibrosis. The ability of serum hyaluronan to differentiate children with advanced fibrosis from those with mild fibrosis was significant (AUC = 0.7767). Laminin did not allow a useful prediction. Two-year lamivudine treatment did not improve histological fibrosis but it caused significant decrease of serum hyaluronan level.

Conclusions: Hyaluronan is a better fibrosis marker than laminin to diagnose children with advanced liver fibrosis. The significant decrease of hyaluronan level during therapy suggests antifibrotic effect of lamivudine in children with chB.