Serum WFA + ‐M2 BP is a non‐invasive liver fibrosis marker that can predict the efficacy of direct‐acting anti‐viral‐based triple therapy for chronic hepatitis C

Summary Background The Wisteria floribunda agglutinin‐positive human Mac‐2‐binding protein ( WFA + ‐M2 BP ) is a new liver fibrosis glycobiomarker with unique fibrosis‐related glyco‐alteration. WFA + ‐M2 BP is also a useful surrogate marker for the risk of developing hepatocellular carcinoma and for the liver functional reserve. Aim To evaluate the diagnostic ability of WFA + ‐M2 BP for liver fibrosis in the clinical setting and the clinical utility of WFA + ‐M2 BP for predicting the efficacy of direct‐acting anti‐viral ( DAA ) treatment for chronic hepatitis C patients. Methods The study included 159 genotype 1 hepatitis C patients who received DAA ‐based treatment (telaprevir or simeprevir) combined with pegylated‐interferon alpha plus ribavirin (108 telaprevir‐ and 51 simeprevir‐based triple treatment). The relation between baseline serum WFA + ‐M2 BP and treatment efficacy was evaluated. Results The serum WFA + ‐M2 BP level significantly increased with the progress of liver fibrosis. Area under the receiver operating characteristic curve analysis identified 2.17 as the cut‐off index ( COI ) for WFA + ‐M2 BP for diagnosing advanced fibrosis. The sustained virological response ( SVR ) rate was significantly, negatively correlated with the serum WFA + ‐M2 BP level. Multiple logistic regression analysis found a low serum WFA + ‐M2 BP level (<2.17 COI ) to be independently associated with SVR (odds ratio, 4.35, P = 0.027). Even for prior nonresponders and patients with the interleukin‐28B minor allele or histological advanced fibrosis, treatment outcome was favourable for patients with a low serum WFA + ‐M2 BP level. Conclusion Serum WFA + ‐M2 BP is a non‐invasive liver fibrosis marker useful for predicting the efficacy of DAA ‐based triple therapy for chronic hepatitis C patients.