HCV gentotype 3 and circulating squamous cell carcinoma antigen (SCCA)-IgM are independently associated with histological features of NASH in HCV infected patients.

Nonalcoholic steatohepatitis enhances the risk of progressive liver disease. In chronic hepatitis C liver steatosis is frequent, especially in genotype 3, but its clinical significance is debated. Since Squamous Cell Carcinoma Antigen (SCCA)-IgM has been associated with advanced liver disease and risk of tumor development, we evaluated its occurrence in chronic hepatitis C and the possible relation with nonalcoholic steatohepatitis at liver biopsy. Using a validated ELISA, serum SCCA-IgM was measured in 91 patients with chronic hepatitis C at the time of liver biopsy performed before antiviral treatment, at the end of treatment and 6 months thereafter, and in 93 HCV negative patients with histological diagnosis of nonalcoholic fatty liver disease, as controls. SCCA-IgM was detected in 33% of chronic hepatitis C patients and in 4% of controls. This biomarker was found more elevated in chronic hepatitis C patients with histological nonalcoholic steatohepatitis and at multivariate analysis SCCA-IgM and HCV genotype 3 were independently associated with nonalcoholic steatohepatitis [OR (95% CI): 6.94 (1.21-40) and 27.02 (4.44-166.6)]. As predictors of nonalcoholic steatohepatitis, HCV genotype 3 and SCCA-IgM had a specificity and a sensitivity of 97% and 44%, and of 95% and 27%, respectively. PPV and NPV were 80% and 86% for HCV genotype 3 vs 73% and 72% for SCCA-IgM. In patients with sustained virologic response to therapy, SCCA-IgM levels decreased significantly, while remained unchanged in non responders. In conclusion, SCCA-IgM is detectable in one third of patients with chronic hepatitis C and significantly correlates with histological nonalcoholic steatohepatitis.