Evaluation of hyaluronic acid and type III procollagen peptide as predictors for treatment response to direct-acting antivirals

doi:10.5501/wjv.v14.i2.106479

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World Journal of Virology

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2220-3249

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Virol. Jun 25, 2025; 14(2): 106479
Published online Jun 25, 2025. doi: 10.5501/wjv.v14.i2.106479

Evaluation of hyaluronic acid and type III procollagen peptide as predictors for treatment response to direct-acting antivirals

Mohamed A Abdelrazek, Ahmed I Elghwab, Ashraf A Tabll, Elsherbiny H Elsayed, Mohammed El Behery

Mohamed A Abdelrazek, Department of Research and Development, Biotechnology Research Center, New Damietta 34517, Egypt

Mohamed A Abdelrazek, Sherbin Central Hospital, Ministry of Health and Population, Shirbin City 35661, Egypt

Ahmed I Elghwab, Elsherbiny H Elsayed, Mohammed El Behery, Department of Chemistry, Faculty of Science, Port Said University, Port Said 8525502, Egypt

Ashraf A Tabll, Department of Microbial Biotechnology, National Research Centre, Dokki 12622, Egypt

Ashraf A Tabll, Department of Immunology, Egypt Centre for Research and Regenerative Medicine, Cairo 11517, Egypt

Author contributions: Abdelrazek MA and Tabll AA conceptualized the study; Abdelrazek MA and Elghwab AI were involved in investigation and the methodology development; Elsayed EH and El Behery M were involved in validation of the study; Abdelrazek MA, Tabll AA, Elsayed EH, and El Behery M supervised the study; and all authors read and approved the final manuscript version to be published.

Institutional review board statement: This study was approved by the Medical Ethics Committee of Faculty of Medicine, Port Said University, approval No. MED (1/6/2023) s.no (96) BIO 004.

Clinical trial registration statement: Not applicable.

Informed consent statement: Prior to participating, all participants provided informed consent.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: Patient information was handled with strict confidentiality and privacy throughout the entire process.

Corresponding author: Mohamed A Abdelrazek, PhD, Associate Research Scientist, Consultant, Researcher, Department of Research and Development, Biotechnology Research Center, 23 July Street, Industrial Zone, New Damietta 34517, Egypt. maabdelrazek@yahoo.com

Received: February 27, 2025
Revised: April 4, 2025
Accepted: May 7, 2025
Published online: June 25, 2025
Processing time: 116 Days and 12.6 Hours

Abstract

BACKGROUND

Treatment response to direct-acting antivirals (DAAs) is a challenging issue and the identification of non-responders patients is very important.

AIM

To evaluate the relation between baseline serum levels of hyaluronic acid (HA) and type III procollagen N-peptide (PIIINP) with direct-acting antivirals treatment failure in Egyptian patients with chronic hepatitis C.

METHODS

Hepatitis C patients (responders and non-responders to sofosbuvir/daclatasvir) were tested for HA and PIIINP using sensitive chemiluminescent immunoassay.

RESULTS

There were distinctly higher PIIINP (P = 0.0003) and HA (P < 0.0001) levels in non-responders than responders patients with a good ability for distinguishing non-responders from patients with sustained virological response (area under the curve = 0.766 for HA and 0.684 for PIIINP). Logistic regression analysis revealed that the HA × PIIINP is the model with the highest predictive ability (area under the curve = 0.809). Diagnostic performances were superior to each marker alone with good sensitivity (74.7%), specificity (74%), positive predictive (68.3%), negative predictive values (79.6%) and accuracy (74.3%). The multiplication of HA × PIIINP is correlated significantly (P < 0.05) with elevated liver enzymes (r = 0.212), decreased albumin (r = -0.26), elevated aspartate aminotransferase-platelet ratio index (r = 0.223) and elevated fibrosis-4 score (r = 0.216) scores.

CONCLUSION

These findings suggested the remarkable role of fibrogensis markers HA and PIIINP in the prediction of hepatitis C virus DAAs treatment response. Multiplying HA with PIIINP values increase the sensitivity to detect treatment success and thus may aim to improve treatment duration and the disease control.

Keywords: Hepatitis C virus; Treatment response; Fibrogensis markers; Hyaluronic acid; Type III procollagen N-peptide

Core Tip: In any medical therapy, treatment response proper prognosis is very important to reduce impacts of the medication and the disease as well. This study highlighted the significant role of hyaluronic acid and type III procollagen N-peptide in the prediction of hepatitis C virus direct-acting antivirals treatment response. Findings revealed that multiplying hyaluronic acid with type III procollagen N-peptide values increase the sensitivity to detect treatment success (74.7% sensitivity, 74% specificity and 74.3% accuracy).