Abstract: Objective The aim of this study was to explore the clinical implication of long non-coding RNA high expression in HCC (LncRNA-HEIH) in serum and exosomes in patients with chronic hepatitis C (CHC). Methods 77 patients with CHC and 40 CHC and 40 patients with hepatocellular carcinoma (HCC) were recruited in this study betweenSeptember 2017 and July 2020, and LncRNA HEIH in serum and exosomes were detected by RT-PCR. The patients received peg-interferon-α and ribavirin therapy for six months and liver biopsies. The multivariate Logistics regression analysis was done, and the prognostic value of LncRNA HEIH in serum and exosomes was analyzed by ROC curves. Results Serum and exosome LncRNA HEIH levels in patients with CHC were (2.3±0.2) and (3.6±0.6), both significantly lower than [(13.4±2.5) and (8.6±1.5), respectively, P<0.05] in patients with HCC; serum and exosome LncRNA HEIH levels in 53 patients with hepatic G0-G1 inflammatory activity were (2.5±0.3) and (3.9±0.6), significantly higher than [(1.9±0.4) and (2.9±0.5), respectively, P<0.05] in 24 patients with significant hepatic inflammatory activity (>G2), and serum and exosome LncRNA HEIH levels in 62 patients with S0-S1 hepatic fibrosis were (2.6±0.4) and (4.1±0.7), significantly higher than [(1.6±0.4) and (2.5±0.5), respectively, P<0.05] in 15 patients with significant hepatic fibrosis (>S2); serum and exosome LncRNA HEIH levels in 59 CHC patients responsive to antiviral therapy were (2.8±0.4) and (4.1±0.6), both significantly higher than [(2.1±0.5) and (3.4±0.6), respectively, P<0.05] in 18 patients nonresponsive to antiviral therapy; the AUC of serum and exosome LncRNA HEIH levels in predicting significant liver histologic activity index (HAI) or hepatic fibrosis were 0.764-0.778 or 0.723-0.736, suggesting some valuable in clinical practice. Conclusion Abnormal serum and exosome LncRNA HEIH levels exist in patients with CHC patients, and the surveillance of them might help predict the hepatic HAI and the response to antiviral therapy.

Key words: Hepatitis C, Exosome, Long non-coding RNA high expression in HCC, Clinical implication