Background/Aim: Prohepcidin is the precursor of hepcidin which is the key regulator
of iron metabolism. It is mainly synthesized in the liver and was claimed to affect the
response to therapy in patients with chronic hepatitis C (CHC).The aim of this study
was to assess s. prohepcidin and iron indices [iron, ferritin and total iron binding
capacity (TIBC)] in patients with CHC and to emphasize their impact on early
virologic response (EVR) to combined pegylated interferon (PEG-1PN) /ribavirin (RBV)
therapy. Subjects & Methods: The cases group comprised 70 adults (56 males and 14
females) with CHC (positive HCV-Ab and HCV-RNA-PCR) whose serum levels of
prohepcidin and iron indices; namely s. iron, s. ferritin and TIBC were assessed
before initiation of PEG-1FN/RBV therapy (beside the routine investigations including
histopathological examination of liver biopsy applying the METAVIR score).
Quantitative HCV-RNA-PCR was done again after the 12th week of therapy to assess
EVR. Twenty healthy subjects were taken as the control group. Results: S.
prohepcidin was non-significantly (P> 0.05) higher while s. ferritin and s. iron were
non-significantly lower in CHC patients (cases group) than in healthy controls
(167+98 0 124157 ng/ml, 1361 92 0 1501119 ng/ml and 57125 0 64125 ug/dl,
respectively). TIBC was similar in both cases and control groups (229187 0 232151
ug/dl). Cases with higher METAVIR fibrosis stages (F) had lower s. prohepcidin
levels (but statistically non significant with p> 0.05) and s. prohepcidin did not show
significant differences in different METAVIR necroinflammatory grades (A). S. iron
showed a statistically significant positive correlation with both the METAVIR grade
and stage (p= 0.002 & 0.037 respectively), while s. ferritin and TIBC did not. In early
responders, s. prohepcidin, s. iron and s. ferritin as well as HCV-RNA-load were nonsignificantly
lower than in non-responders. At cut off value = 179 ng/ml; s.
prohepcidin was 54% sensitive and 69% specific for prediction of EVR in the studied
cases. In conclusion: S. prohepcidin is relatively increased in CHC patients and
higher rates of EVR to combined PEG-oN/RBV therapy would be predicted in patients
with lower serum -prohepcidin, -iron and -ferritin levels. |
