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Abstract
Background: The possible markers of liver fibrosis (plasma YKL-40, PIIINP, MMP-2 and TIMP-1) were measured at the start (t0) and end of treatment (t12) with ! -interferon and ribavirin and repeated at6-months follow-up (t18) in 51 patients with chronic hepatitis C. Methods: We evaluated 1) whether treatment response is reflected by a decrease in these markers during antiviral therapy; 2) whether these markers reflect the activity of the disease; and 3) whether these markers could be used as predictors of the treatment response. Results: Baseline plasma YKL-40, MMP-2, PIIINP and TIMP-1 were significantly increased in patients compared to normal controls. In responders ( n r = r 30), plasma YKL-40 ( P r < r 0.05), MMP-2 ( P r < r 0.05) and TIMP-1 ( P r < r 0.001) decreased significantly at t18, and no changes were observed at t12. Plasma PIIINP was unchanged in responders. In non-responders ( n r = r 19), plasma MMP-2 ( P r < r 0.01) and TIMP-1 ( P r < r 0.01) decreased significantly at t18, whereas plasma YKL-40 and PIIINP were unchanged. The markers were significantly correlated at baseline ( P r < r 0.001). Plasma PIIINP at baseline could predict treatment response ( P r = r 0.01). Conclusions: Response to antiviral treatment is associated with a decrease in the fibrogenetic markers, but the markers do not reflect the biochemical disease activity during treatment. Baseline plasma PIIINP was the only marker predicting treatment response.