Sa1025 Hepcidin and Chronic Hepatitis C Virus: Exploring the Controversy

Abstract

Background and aim of the work: There are currently about 170 million hepatitis C virus (HCV) infected persons worldwide .Hepcidin has a central role in iron homoeostasis, as it decreases iron release from macrophages and iron absorption from intestinal enterocytes, its correlation to chronic hepatitis C (CHC), hepatic iron load, and fibrosis is controversial between different studies. Thus, we aim to asses plasma hepcidin levels in CHC patients and to investigate the association of this molecule with iron parameters, hepatic inflammatory and fibrotic scores. Patients and methods: 38 CHC patients mean age 42.0 ±7.4 years 34 males and 4 females (group1) and 38 age and sex matched healthy controls (group 2) were included in the study. Both groups were subjected to blood tests for serum ferritin, serum iron, serum hepcidin, complete blood picture (CBC). Group 1 patients were subjected to ultrasound guided liver biopsy for assessment of hepatic activity and fibrosis scores according to METAVIR as well as hepatic iron stores. Results: Mean serum hepcidin and ferritin levels were significantly higher among cases with HCV compared to controls (77.4±48.5ng/ml vs43.9±22.9 ng/ml p=0.000 and 165.9±120.9ng/ml vs and 98.5±77.6 ng/ml p=0.005, respectively).There is a significant positive correlation between serum hepcidin level and serum ferritin level(r=0.563), Metavir fibrosis score (r=0.666) Metavir activity scores(r= 0.36,) and hepatic iron stores(r=0.378). Serum Hepcidin was significantly higher among CHC patients with fibrosis stage (F3-F4) than those with fibrosis stage (F0-F2) (117.4±51.4 ng/ml vs 51.3 ± 21.9ng/ml respectively p=0.000 ), also it was significantly higher among CHC patients with activity scores(A2-A3) than among those with activity score(A0-A1) (200.6±117.2 vs 153.6± 121.9 respectivelyp=0.03).Serum Hepcidin could predict stage 3 fibrosis at a cut off level of 73.8 with a sensitivity of 80% and specificity of 83%. Conclusion: Serum Hepcidin is significantly higher among CHC patients than normal controls and is positively correlated to stage of hepatic fibrosis , grade of hepatic inflammation and serum ferritin