• Carolina Coimbra Marinho, Thales Bretas, Izabela Voieta, Leonardo Campos de Queiroz, Raiza Ruiz-Guevara, Antônio Lúcio Teixeira, Carlos Maurício Antunes, Aluízio Prata, and José Roberto Lambertucci.
• Programa de Pós-Graduação em Ciências da Saúde, Infectologia e Medicina Tropical, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil. carolinacmarinho@gmail.com
• Mem. Inst. Oswaldo Cruz. 2010 Jul 1; 105 (4): 471-8.

AbstractNon-invasive markers of fibrosis have been used to diagnose liver fibrosis in a variety of diseases. Hyaluronic acid (HA) and collagen IV (C-IV) levels were measured in the sera of patients from an endemic area for schistosomiasis in Brazil to diagnose and to rank the intensity of liver fibrosis. Seventy-nine adult patients with schistosomiasis, in the age range of 21-82 years (49 +/- 13.4) were submitted to clinical and ultrasonographic examinations. Ultrasound was employed to diagnose and categorise liver fibrosis according to World Health Organization patterns. Serum HA and C-IV levels were measured using commercial ELISA kits. Ultrasound revealed six patients with intense liver fibrosis, 21 with moderate, 23 with light and 29 without. Serum HA was able to separate individuals with fibrosis from those without (p < 0.001) and light from intense fibrosis (p = 0.029), but C-IV was not (p = 0.692). The HA diagnostic accuracy for fibrosis was 0.89. The 115.4 ng/mL cut-off level diagnosed patients with fibrosis (sensitivity 0.98, specificity 0.64). HA correlated positively with portal hypertension. Periportal fibrosis (subjective evaluation), age and collateral circulation predicted HA increase. In conclusion, we propose that serum HA can be used to identify patients with liver fibrosis in an endemic area for schistosomiasis mansoni in Brazil.

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