Hepatitis C Clinical Trial
Official title:
Evaluation of Vitamin D and Iron Status in Chronic Hepatitis C Virus Patients Before and After Treatment
HCV is associated with vitamin D deficiency. Iron overload is frequently occurred in chronic hepatitis C patients; more than one third of HCV positive patients have elevated serum iron, ferritin, and transferrin which were linked to bad prognosis. Hepcidin is a regulatory peptide that is mainly synthesized by the liver cells and plays an important role in iron homeostasis. There is an interaction between iron metabolism and vitamin D metabolism. Iron is essential for vitamin D activation and vitamin D deficiency is associated with elevated hepcidin level, which partly accounts for anemia associated with vitamin D deficiency. Up to our knowledge, little is known about the association between vitamin D status and iron metabolism in HCV patients.
Hepatitis C virus (HCV) is one of the global public health problems. World Health
Organization (WHO) reported that more than 80 million people all over the world are infected
with HCV. Approximately 700000 persons die every year from hepatitis C-related
complications. Egypt is one of the highest prevalence rates of HCV, worldwide.
Vitamin D possesses anti-inflammatory, anti-oxidant, anti-fibrotic and immunomodulatory
effects. HCV is associated with vitamin D deficiency. Liver plays an important role in
vitamin D hydroxylation and iron metabolism. It stores iron, synthesizes iron transporting
protein (transferrin), iron storage protein (ferritin) and an iron regulatory peptide
(hepcidin). Iron overload is frequently occurred in chronic hepatitis C patients. More than
one third of HCV positive patients have elevated serum iron, ferritin, and transferrin which
were linked to bad prognosis. Excess iron is catalyzed by the rapid Fenton reaction
producing hydroxyl radicals from hydrogen peroxide and superoxide (10), which induces lipid
peroxidation and cellular damage. Hepcidin is a regulatory peptide that is mainly
synthesized by the liver cells and plays an important role in iron homeostasis via
inhibiting iron absorption and preventing iron efflux from macrophages and thus prevents
normal recycling of the iron needed for erythropoiesis. In addition, hepcidin inhibits HCV
replication via activation of STAT3. A reduced serum hepcidin has been reported in chronic
HCV patients which was correlated to the severity of liver histopathological changes and
related to iron overload in these patients.
There is an interaction between iron metabolism and vitamin D metabolism. Iron is essential
for vitamin D activation and vitamin D deficiency is associated with elevated hepcidin
level, which partly accounts for anemia associated with vitamin D deficiency. Up to our
knowledge, little is known about the association between vitamin D status and iron
metabolism in HCV patients.
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