Serum WFA⁺-M2BP is a non-invasive liver fibrosis marker that can predict the efficacy of direct-acting anti-viral-based triple therapy for chronic hepatitis C

Background The Wisteria floribunda agglutinin-positive human Mac-2-binding protein (WFA⁺-M2BP) is a new liver fibrosis glycobiomarker with unique fibrosis-related glyco-alteration. WFA⁺-M2BP is also a useful surrogate marker for the risk of developing hepatocellular carcinoma and for the liver functional reserve. Aim To evaluate the diagnostic ability of WFA⁺-M2BP for liver fibrosis in the clinical setting and the clinical utility of WFA⁺-M2BP for predicting the efficacy of direct-acting anti-viral (DAA) treatment for chronic hepatitis C patients. Methods The study included 159 genotype 1 hepatitis C patients who received DAA-based treatment (telaprevir or simeprevir) combined with pegylated-interferon alpha plus ribavirin (108 telaprevir- and 51 simeprevir-based triple treatment). The relation between baseline serum WFA⁺-M2BP and treatment efficacy was evaluated. Results The serum WFA⁺-M2BP level significantly increased with the progress of liver fibrosis. Area under the receiver operating characteristic curve analysis identified 2.17 as the cut-off index (COI) for WFA⁺-M2BP for diagnosing advanced fibrosis. The sustained virological response (SVR) rate was significantly, negatively correlated with the serum WFA⁺-M2BP level. Multiple logistic regression analysis found a low serum WFA⁺-M2BP level (<2.17 COI) to be independently associated with SVR (odds ratio, 4.35, P = 0.027). Even for prior nonresponders and patients with the interleukin-28B minor allele or histological advanced fibrosis, treatment outcome was favourable for patients with a low serum WFA⁺-M2BP level. Conclusion Serum WFA⁺-M2BP is a non-invasive liver fibrosis marker useful for predicting the efficacy of DAA-based triple therapy for chronic hepatitis C patients.