Hepcidin: A New Noninvasive Biomarker for Histological Cirrhosis in Hepatitis C Virus Patients
Hanan El-Bassat
Tropical Medicine Department, Faculty of Medicine Tanta University, Egypt.
Lobna Aboali
Tropical Medicine Department, Faculty of Medicine Tanta University, Egypt.
Hanan Alshenawy
Pathology Department, Faculty of Medicine Tanta University, Egypt.
Atif Taha
Internal Medicine Department, Faculty of Medicine Tanta University, Egypt.
Rasha A. Alm El-Din *
Medical Microbiology and Immunology Department, Faculty of Medicine Tanta University, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Aim: To investigate the potential role of serum hepcidin as a biomarker for histological cirrhosis in hepatitis C virus patients.
Methods: Serum hepcidin was measured in 80 patients with hepatitis C virus and 15 age and sex matched healthy subjects as control. Liver biopsy was available for 50 patients only. All subjects were divided as follows:
Group I: 50 patients with chronic HCV waiting for treatment decision. They were subdivided according to liver fibrosis stage into:
Group I (a): 39 patients with fibrosis stage F1, F2 and F3.
Group I (b): 11 patients with histological cirrhosis F4.
Group II: 30 HCV cirrhotic patients.
Group III: 15 age- and sex-matched healthy subjects as control.
Results: Serum hepcidin concentration was significantly lower in patients with chronic HCV, histological cirrhosis and cirrhotic patients than healthy control and was lowest in those with cirrhosis (PË‚0.001). Serum hepcidin level was significantly positively correlated with serum ferritin, transferrin saturation, ALT, AST, hemoglobin level, albumin and hepatic iron but negatively correlated with serum bilirubin. Serum hepcidin decrease with progression of liver fibrosis and was lowest in those with histological cirrhosis and clinically proven cirrhosis. In contrast, serum ferritin increased progressively with increasing stages of fibrosis and was highest in those with histological cirrhosis and cirrhotic patients.
Conclusions: Increasing hepatic fibrosis is associated with decreased hepcidin serum level. This indicates that hepcidin may serve as a potential biomarker for fibrosis and cirrhosis. Hepcidin is positively correlated with hepatic iron and liver enzymes but negatively correlated with the stage of fibrosis.
Keywords: Hepcidin, iron overload, HCV, cirrhosis