الفهرس 
COVEROnly 14 pages are availabe for public view
 |  | from | 254 |  |  |
| | | from | 254 | | |
Abstract
According to World Health Organization (WHO) data, there are currently about 170 million HCV-infected persons worldwide, which is approximately 3% of the human population.
pathological iron deposits have been observed in about 50% of patients with chronic HCV infection.
The underlying mechanisms of the hepatic iron accumulation in HCV-infected liver are still poorly understood.
parenchymal iron accumulation in HCV patients has been linked to suppressed levels of the systemic iron hormone hepcidin, in addition to the previously purposed two mechanisms that explain the iron overload in CHC patient as hemochromatosis gene mutations or as a result of turnover from damaged hepatocytes.
Hepcidin is a polypeptide synthesized in the liver and found in the serum and urine. It has a central role in iron homoeostasis, as it decreases iron release from macrophages and iron absorption from intestinal enterocytes through its binding to the iron exporter protein, ferroportin. Iron homoeostasis, hypoxia and inflammation are the major regulators of hepcidin production.
This study was done to asses plasma hepcidin levels in chronic hepatitis C patients and to investigate the association of this molecule with iron parameters, histological activity index, and liver fibrosis scores.
This study was done in collaboration between Tropical Medicine Department Ain Shams University Hospital and National research center (Internal Medicine Department/ Clinical and Chemical pathology Department/pathology Department).
After Complete history taking, thorough clinical examination and applying inclusion and exclusion criteria we collected the results of the following routine investigations done by proven chronic HCV patients who came to for receiving the standard of care (pegylated interferon plus Ribavirin) as treatment for chronic HCV:
•Complete blood count, Liver enzymes and complete liver function tests.
•Quantitative HCV-RNA by real time pCR, Hepatitis B surface antigen (HBsAg) and HB core IgG.
•Anti nuclear antibody, Alpha feto protein.
•Abdominal ultrasonography.
Ultrasound guided liver biopsy was done for the selected patients for determination of the following:
•Activity index and fibrosis scores according to Metavir. Hepatic iron deposites according to Deugnier et al score.
All the included subjects (patients-controls) in this study were subjected to the following laboratory analysis:
•Complete blood picture, Serum iron & ferritin, Serum hepcidin, Serum HCV-Antibodies.
The results of this study revealed:
•Higher mean serum hepcidin and ferritin among cases with HCV compared to controls and the difference is highly significant statistically.
•There is a lower mean serum hepcidin among cases in quartile 1 (lowest quartile of ferritin) compared to other groups and the difference is highly significant statistically.
•52% of our CHC patients showed mild to severe hepatic iron overload.
•There is significant positive correlation between serum hepcidin level and serum ferritin levels, Metavir fibrosis and activity scores and hepatic iron score.
•The best predictor of the fibrosis stage from all the studied independent variables is the serum hepcidin level.