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Fibrosis is a hallmark histologic event of viral hepatitis and is characterized by the excessive accumulation and reorganization of the extracellular matrix (ECM). The gold standard for assessment of fibrosis is liver biopsy. As this procedure has various limitations, including risk of patient injury and sampling error. Serum Hyaluronic acid as non invasive marker for liver fibrosis is desirable. The present study aims to determine the serum hyaluronic acid (HA) levels as biochemical marker of hepatic fibrosis and cirrhosis and correlate it with the degree of hepatic fibrosis. Serum HA level in chronic hepatitis patients (n=60) are divided into two groups, group1: included 30 patients positive for anti-HCV (antibodies), group 2 included 30 patients positive for HBsAg, and controls (n=10) were assessed by ELISA and liver histopathological parameters were evaluated by the modified Knodell score and microscopic examination of liver biopsies from patients. Individuals in healthy control group have normal levels of HA (mean 14.3, SD: 5.5) while the levels of HA were elevated in patients of HCV alone (mean 103.6±28.0) and in patient of HCV (mean 104.5± 37.5).Also levels of HA were poorly elevated in HBV alone (mean 62.2± 15.5) and in HBV (mean 45.8± 12.4). showed that serum HA levels are well correlated with HAI in patients of HBV & HCV groups where, there was significant increase in HA levels by increase of HAI by liver biopsy P < 0.001.HA levels and stages of fibrosis were well correlated in patients of HBV and HCV group. Where, this is a significant increase in HA levels when Considering F0 to F6 scores by liver biopsy (P < 0.001). Serum HA is a useful non-invasive marker of liver fibrosis. There is a strong positive correlation between serum HA levels and degree of liver fibrosis. The concentration of serum HA rises according to progression of liver fibrosis.

Serum hyaluronic acid as non invasive biomarker to predict liver fibrosis in viral hepatitis patients.