Is neutrophil gelatinase associated lipocalin useful in hepatitis C virus infection?

Alessio Strazzulla

INTRODUCTION AND AIM: Neutrophil gelatinase associated lipocalin (NGAL) is a novel biomarker of renal impairment but also a marker of inflammation. For the first time, we evaluated the evolution of NGAL in patients infected by hepatitis C virus (HCV) before and during treatment with directly acting antivirals (DAAs).
METHODS: NGAL was measured in a group of patients with chronic HCV infection ranked, at baseline, by age, gender , anti-hypertensive therapy, HCV viral load, liver fibrosis stage and, either at baseline and after 1 year, estimated glomerular filtration rate (eGFR). Then, NGAL and eGFR evolutions were monitored in a subgroup of patients who started antiviral therapy with DAAs. Differences of median NGAL levels were evaluated through Wilcoxon-Mann-Whitney test for non parametric data. Differences in dichotomous variables were evaluated through Χ2 test. At baseline, a univariate regression analysis was conducted to verify if NGAL values correlated with other quantitative variables (age, FIB-4, APRI, and eGFR).
RESULTS: Overall, 48 patients were enrolled, 8 of them starting HCV treatment. At baseline, statistically significant differences were found in median NGAL values only between patients with eGFR118.11 ng/dl were compared with patients with NGAL≤118.11 ng/dl, not statistically significant differences were present for age, gender, chronic kidney disease classification and liver fibrosis (p >0.05). Linear correlation was found between NGAL and both age (p=0.0475) and eGFR (p=0.0282) values. Not significant prediction of NGAL at baseline for eGFR evolution 1 year later was demonstrated. Interestingly, in the 8 patients treated with DAAs, median NGAL significantly increased at week 12 compared to baseline (p=0.0239).
CONCLUSION: In conclusion, our results suggest that NGAL should be further evaluated as an adjunct marker of kidney function in these patients.

Simone Agnello
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