Have you had any experience with the use of serum hyaluronic acid (HA) levels to monitor the progression of chronic liver disease? This serological test is commonly used in Japan in place of liver biopsy to distinguish between fibrosis and cirrhosis in patients with HCV and alcoholic liver disease. While this test may not replace liver biopsy in the US, do you think it could provide valuable information reflecting the histopathological changes occurring in the liver between biopsies, and possibly reduce the frequency of liver biopsy?
 
Thank you,
 

We do not use it, but there is intense in terest in developing "panels" of tests that collectively can differentiate stage of fibrosis. they are not yet ready for prime time, so we will watch with interest.