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. 2020 Oct 1:2020:8539804.
doi: 10.1155/2020/8539804. eCollection 2020.

Decrease in Chitinase 3-Like Protein 1 Levels Reflects Improvement in Liver Fibrosis after HCV Eradication

Qian Kang  1 , Jianhong Chen  2 , Hao Luo  1 , Ning Tan  1 , Hui Gao  1 , Xiaxia Zhang  3 , Min Yu  1 , Dan Liu  1 , Hongli Xi  1 , Yaoyu An  1 , Yifan Han  1 , Ran Cheng  1 , Xiaoyuan Xu  1
Affiliations

Decrease in Chitinase 3-Like Protein 1 Levels Reflects Improvement in Liver Fibrosis after HCV Eradication

Qian Kang et al. Dis Markers. .

Abstract

Aim: The success of direct-acting antivirals (DAAs) against hepatitis C virus is a major breakthrough in hepatology. Previous studies have shown that chitinase 3-like protein 1 (CHI3L1) was a marker for staging of liver fibrosis caused by HCV. In this investigation, we used CHI3L1 as a surrogate marker to compare dynamic hepatic fibrosis variations following the elimination of HCV among cases receiving sofosbuvir (SOF)-based regimens and pegylated interferon/ribavirin (PR) treatments.

Methods: The study enrolled 105 patients, including 46 SOF-based regimens treated patients, 34 PR-experienced patients, and 25 untreated patients. Serum samples and clinical data were obtained at the baseline, the end of treatment, and at weeks 24 and 48 after treatments.

Results: First, we found that serum level of CHI3L1 correlated moderately but significantly with LSM (r = 0.615, P < 0.001) at the baseline, and diagnosed liver cirrhosis at baseline with high accuracy (AUC = 0.939) by ROC analysis. So we explored CHI3L1 as a sensitive biomarker to monitor the regression of liver fibrosis after HCV eradication. We found that the serum CHI3L1 level of CHC cases receiving SOF-based regimen treatments was markedly reduced immediately after treatment compared with that at the baseline (123.79 (118.55) vs. 118.20 (103.68), P = 0.001). For cases undergoing PR treatment, the serum CHI3L1 decreased significantly at week 24 posttreatment compared with that at the baseline (69.98 (51.44) vs 89.15 (110.59), P = 0.016). For the untreated cirrhotic patients, CHI3L1 levels increased at week 96 follow-up compared with that at the baseline (194.73 (172.46) vs. 89.50 (242.97), P = 0.048), reflecting continued worsening of liver fibrosis.

Conclusion: CHI3L1 is suggested to be the sensitive marker to monitor fibrosis variations in weeks during treatments and after achieving SVR. It has the potential to allow the identification of early treatment failure for a timely switch to alternative treatment and to allow monitoring progression of fibrosis as a risk factor for liver cirrhosis.

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Conflict of interest statement

There are no conflicts of interest declared by the authors for this study.

Figures

Figure 1
Figure 1
Correlation between serum CHI3L1 levels and LSM at baseline in all patients. There were positive correlations between serum CHI3L1 levels and LSM (r = 0.615, P < 0.001).
Figure 2
Figure 2
Area under the ROC curve of CHI3L1 in the diagnosis of liver cirrhosis. ROC: receiver operating characteristic curve.
Figure 3
Figure 3
Dynamic changes of serum CHI3L1 in different treatment groups at different time points. T0: baseline; T1: end of treatment; T2: 24 weeks after treatment; T3: 48 weeks after treatment. U0: baseline; U1: follow-up of 24 weeks; U2: follow-up of 48 weeks; U3: follow-up of 72 weeks; U4: follow-up of 96 weeks.
Figure 4
Figure 4
Distributions of different categories of responses to the treatments by CHI3L1. T1/U1: at the end of treatment; T2/U2: at 24 weeks after treatment; T3: at 48 weeks after treatment. Red color indicates rapid ascenders, and yellow color indicates slow ascenders; green color indicates rapid decliner, and grey color indicates slow decliners.
Figure 5
Figure 5
The dynamic changes of serum CHI3L1 of DAA-treated patients and PR-experienced patients in different subgroups. T0: at the baseline; T1: at the end of treatment; T2: at 24 weeks after treatment; T3: at 48 weeks after treatment.
Figure 6
Figure 6
The dynamic changes of CHI3L1 level in LC and non-LC patients.
See this image and copyright information in PMC

References

    1. Committee T. G. R. Guidelines for the Care and Treatment of Persons Diagnosed with Chronic Hepatitis C Virus Infection. Geneva: World Health Organization; 2018. WHO guidelines approved by the guidelines review committee. - PubMed
    1. Ogawa E., Furusyo N., Nomura H., et al. Short-term risk of hepatocellular carcinoma after hepatitis C virus eradication following direct-acting anti-viral treatment. Alimentary Pharmacology & Therapeutics. 2018;47(1):104–113. doi: 10.1111/apt.14380. - DOI - PubMed
    1. D'Ambrosio R., Aghemo A., Rumi M. G., et al. A morphometric and immunohistochemical study to assess the benefit of a sustained virological response in hepatitis C virus patients with cirrhosis. Hepatology. 2012;56(2):532–543. doi: 10.1002/hep.25606. - DOI - PubMed
    1. Bernstein D., Kleinman L., Barker C. M., Revicki D. A., Green J. Relationship of health-related quality of life to treatment adherence and sustained response in chronic hepatitis C patients. Hepatology. 2002;35(3):704–708. doi: 10.1053/jhep.2002.31311. - DOI - PubMed
    1. Conti F., Buonfiglioli F., Scuteri A., et al. Early occurrence and recurrence of hepatocellular carcinoma in HCV-related cirrhosis treated with direct-acting antivirals. Journal of Hepatology. 2016;65(4):727–733. doi: 10.1016/j.jhep.2016.06.015. - DOI - PubMed