Serum marker may flag liver fibrosis in chronic HBV

By Eleanor McDermid

Serum levels of Wisteria floribunda agglutinin-positive Mac-2-binding protein (WFA⁺-M2BP) may reflect the severity of liver fibrosis in patients with chronic hepatitis B virus (HBV) infection, say researchers.

The marker was associated with the presence of fibrosis, particularly with advanced fibrosis, report Hirayuki Enomoto (Hyogo College of Medicine, Japan) and study co-authors.

The team measured serum levels of WFA⁺-M2BP, a proposed marker of liver fibrosis in patients with chronic liver diseases such as chronic hepatitis C virus infection and nonalcoholic fatty liver disease, in 189 treatment-naïve patients, aged a median of 44 years, with chronic HBV.

Only 11 of these patients were free of liver fibrosis (F0), while 97 had portal fibrosis without septa (F1), 37 had portal fibrosis with rare septa (F2), 28 had numerous septa without cirrhosis (F3) and 16 had liver cirrhosis (F4).

Levels of WFA⁺-M2BP increased with the severity of fibrosis, at medians of 0.9, 1.4, 1.6 and 3.1 cutoff index for stages F0/F1, F2, F3 and F4, respectively. All differences were statistically significant (p<0.001 except p<0.01 for F2 vs F4) except for that between F2 and F3 (p=0.53).

And WFA⁺-M2BP performed well when tested against other potential fibrosis markers - the aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio, platelet count, the AST to platelet ratio index, hyaluronic acid and the Fibrosis-4 (FIB-4) index.

It was one of the most accurate markers for patients with F4 fibrosis, having an accuracy, based on receiver operating characteristics curve analysis, of 87%, as did the FIB-4 index and hyaluronic acid. WFA⁺-M2BP was the second most accurate marker for at least F3 fibrosis, with an accuracy of 77%, after hyaluronic acid, which had an accuracy of 78%.

WFA⁺-M2BP levels strongly correlated with those of a number of other markers, including AST, ALT and hyaluronic acid (p<0.001 for all). The team also found that WFA⁺-M2BP correlated strongly with the liver inflammation marker interferon γ inducible protein-10 (p<0.001), suggesting that elevated WFA⁺-M2BP may reflect inflammation, as well as fibrosis.

Indeed, it was a good predictor of liver inflammation, with accuracies of 76% and 78% for moderate and severe inflammation, respectively.

"WFA⁺-M2BP may not be a single laboratory liver fibrosis marker but one that can be used as serum marker related to liver inflammation activity", write the researchers in Hepatology Research.

This means that further study is needed to determine exactly howh WFA⁺-M2BP can best be used in clinical practice, they note.

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