P838 DISTURBED ENERGY METABOLISM AND LIPID PROFILE AFTER A 4 WEEK HIGH ORAL FRUCTOSE CHALLENGE: POSSIBLE ROLE OF BILE ACIDS

Abstract

significance is still debated. Since SCCA-IgM immunocomplexes have been associated with more advanced liver disease and increased risk of HCC development, the purpose of this study was to evaluate the occurrence of this biomarker and its possible relation with the presence of NASH at liver biopsy. Methods: In 91 patients with biopsy proven chronic hepatitis C serum samples were tested for SCCA-IgM by ELISA. Sera of 92 consecutive HCV negative patients with histological NAFLD were included as controls. Results: SCCA-IgM was detected in 33% of HCV patients at the time of liver biopsy, but only in 4% of patients with NAFLD. In chronic hepatitis C this biomarker was found more elevated in patients with concomitant histological features of NASH and at multivariate analysis SCCA-IgM and genotype 3 were independently associated with this histologic feature. Referred to NASH, specificity and sensitivity were 97% and 44% for HCV genotype 3 vs 95% and 26% for SCCA-IgM, while PPV and PNV were 80% and 86% for the former vs 70% and 73% for the latter variable. After antiviral treatment, in HCV patients with SVR, SCCA-IgM values decreased significantly during treatment and remained persistently low after the end of therapy, while remained unchanged in the other patients. Conclusions: SCCA-IgM was detectable in about one third of patients with chronic hepatitis C and its presence was significantly associated with histological NASH, independently of the infecting genotype.