Serum hyaluronic acid and laminin in children with chronic hepatitis B

Objective: To evaluate whether hyaluronic acid and laminin P1 serum concentrations reflect the presence of liver fibrosis and/or cirrhosis in children with chronic hepatitis B infection. Design and patients: Serum concentrations of hyaluronic acid and laminin P1 were correlated with several clinical, biochemical and histological parameters in 54 children (mean age, 7.7 years) with chronic hepatitis B, in 13 healthy carriers, and in 18 age- and sex-matched controls. Results: Levels of hyaluronic acid in patients with cirrhosis were significantly higher than in controls and patients without cirrhosis. Concentrations above 100 μg/l were observed only in children with cirrhosis, but sensitivity was low. Serum concentrations of laminin P1 in patients with cirrhosis were significantly higher than in controls, but overlapped with values in the other patient subgroups. The extent of fibrosis, assessed by computerized histomorphometry, correlated significantly with serum concentrations of both hyaluronic acid and laminin P1; no cut-off value discriminated between small and large lesions. The concentrations of hyaluronic acid and laminin P1 were highest in patients with marked capillarization of liver sinusoids at electron microscopy and/or thickened lesser omentum at sonography, two alleged features of portal hypertension. Conclusions: The correlation between serum concentrations of hyaluronic acid and laminin P1 and the presence of liver fibrosis and/or cirrhosis in children with chronic hepatitis B virus infection was statistically significant but clinically limited.