Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan.
BMC Gastroenterol. 2012 Aug 28;12:117. doi: 10.1186/1471-230X-12-117.
Hepatitis C virus (HCV) infection is one of the leading causes of chronic liver disease (CLD). About 80% of those exposed to the virus develop a chronic infection. Hyperhomocysteinemia, which is an independent risk factor for atherosclerotic vascular disease and thromboembolism, may develop in HCV-infected patients although altered alanine amino transferase (ALT) enzyme levels are generally associated with damage to liver cells. The gold standard therapy for chronic hepatitis C patients is pegylated interferon combined with an anti-viral drug (ribavirin). The current study aimed to investigate the effect of antiviral therapy on plasma homocysteine (Hcy) levels in HCV patients in addition to other parameters.
532 HCV-infected patients and 70 healthy controls were recruited for the study. All patients were subjected to laboratory investigations including HCV-RNA levels, complete blood cell counts, serum levels of homocysteine, ALT, alkaline phosphatase (ALP), lipid profile and liver ultrasonographic examination. The outcome of treatment with pegylated interferon α plus ribavirin treatment and sustained virologic response (SVR) was determined 6-9 months post-therapy.
Hyperhomocysteinemia was found in 91.35% of HCV-infected patients. The difference in plasma Hcy concentrations reached statistical significance between the patient and control groups. ALT, cholesterol and triglycerides (TGs) levels were found higher than normal in the patients group. After receiving a combined therapy for 24 weeks, 43.66% patients showed an SVR (responders); 30.98% patients were non-responders while 25.35% patients initially responded to therapy but again retrieved positive status of HCV infection six months post-therapy (relapse-cirrhotic patients). The mean levels of plasma Hcy, ALT and ALP were significantly reduced in responders within 10 weeks of therapy when compared with non-responders and relapse-cirrhotic patients.
Elevated homocysteine levels in serum due to HCV infection can be reduced to normal range with the standard interferon α plus ribavirin treatment. This study highlights the significance of the measurement of serum homocysteine levels in the diagnosis and monitoring of HCV infection treatment in addition to other laboratory parameters.
丙型肝炎病毒（HCV）感染是慢性肝病（CLD）的主要原因之一。大约 80%接触该病毒的人会发展为慢性感染。高同型半胱氨酸血症是动脉粥样硬化性血管疾病和血栓栓塞的独立危险因素，尽管丙型肝炎病毒感染患者的丙氨酸氨基转移酶（ALT）水平通常与肝细胞损伤有关，但可能会发生改变。聚乙二醇干扰素联合抗病毒药物（利巴韦林）是慢性丙型肝炎患者的金标准治疗方法。本研究旨在探讨抗病毒治疗对 HCV 患者血浆同型半胱氨酸（Hcy）水平的影响，以及其他参数的影响。
招募了 532 例 HCV 感染患者和 70 例健康对照者进行研究。所有患者均接受实验室检查，包括 HCV-RNA 水平、全血细胞计数、血清同型半胱氨酸、ALT、碱性磷酸酶（ALP）、血脂谱和肝脏超声检查。治疗后 6-9 个月，用聚乙二醇干扰素α加利巴韦林治疗的疗效和持续病毒学应答（SVR）。
91.35%的 HCV 感染患者存在高同型半胱氨酸血症。患者组和对照组之间血浆 Hcy 浓度的差异有统计学意义。丙氨酸氨基转移酶、胆固醇和甘油三酯（TGs）水平高于正常。接受 24 周联合治疗后，43.66%的患者表现出 SVR（应答者）；30.98%的患者为无应答者，而 25.35%的患者最初对治疗有反应，但在治疗后 6 个月再次检测到 HCV 感染呈阳性（复发-肝硬化患者）。与无应答者和复发-肝硬化患者相比，应答者在治疗 10 周内 Hcy、ALT 和 ALP 的平均水平显著降低。
HCV 感染导致的血清同型半胱氨酸水平升高可通过标准干扰素α加利巴韦林治疗降至正常范围。本研究强调了在诊断和监测 HCV 感染治疗中，除了其他实验室参数外，测量血清同型半胱氨酸水平的重要性。
