Serum immunoreactive prolyl hydroxylase protein, galactosylhydroxylysyl glucosyltransferase activity, and the aminoterminal propeptide of type III procollagen (S-Pro(III)-N-P) were measured in twenty patients with cirrhosis and ninety with various infectious diseases, and the values were compared with those in sixty apparently healthy Nigerians. The means for all three markers were elevated significantly in the patients with cirrhosis (P less than 0.001), acute viral hepatitis (P less than 0.001), amoebic liver abscess (P less than 0.001) and the early stages of Schistosoma mansoni infection (P less than 0.001 for S-Pro(III)-N-P, P less than 0.005 for the two other markers). The mean S-Pro(III)-N-P was also distinctly elevated during the early stages of Schistosoma haematobium infection (P less than 0.01) and filariasis (P less than 0.001), whereas none of the three markers was elevated during an acute attack of malaria. Significant correlations were found between the values for the three markers within the groups of patients with cirrhosis, amoebic liver abscess and schistosomiasis, the correlations for the pooled group of all patients being highly significant (P less than 0.001). The data suggest that elevated hepatic collagen formation is found not only in cirrhosis but also in several infectious diseases. The three serum markers may be useful for showing the stages of active collagen formation in various liver diseases and for predicting the development of fibrosis in acute cases if the values remain elevated.

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