Oxidative stress and antioxidants in hepatitis C virus patients

ABSTRACT

Malondialdehyde [MDA] is widely used as an index of oxidative injury induced by oxygen free radical on lipid membranes. Vitamin E [Vit.E] has been found to protect the liver against oxidative stress. There are inverse correlations between the increase of peroxide and the decrease of the ceruloplasmin [Cp] in patients with hepatitis C virus [HCV]. To estimate serum levels of malondialdehyde [MDA], of vitamin E [Vit.E] and ceruloplasmin [Cp], and to correlate their serum levels with the presence of cirrhosis and hence their use as non invasive blood markers. This study is a cross sectional study conducted on 40 newly discovered HCV infected cases receiving no treatment for hepatitis C virus [HCV] attending the Tropical Clinic in Cairo University Hospitals. They were 25 females and 15 males [age ranged from 25 to 60 years] as well as 15 age and sex matched healthy control subjects. Diagnosis of HCV was made by hepatitis markers using microparticle enzyme immunoassay [MEIA]. All patients were subjected to full history taking, clinical examination, abdominal ultrasonography, Laboratory tests included serum AST, ALT, total protein and albumin by routine analytical methods. Serum MDA level was estimated by thiobarbituric acid [TBA] chemical method, serum vitamin E by isocratic HPLC/UV method and serum Cp by immuno-nephlometric method. Patients were classified into two groups Group I [patients with HCV infection] that was further divided into; Group I [a] Included 26 HCV patients without cirrhosis. Group I [b] 14 HCV patients with cirrhosis according to their ultrasonographic findings. Group II [control group] Were HCV-antibody negative. The level of serum Cp did not differ between groups I [a], I [b] and II. The mean values of serum levels of MDA were significantly higher in all HCV positive patients compared to controls [p<0.001] and were higher in group I [a] compared to group I [b] with statistically significant difference [p<0.000]. The mean values of serum levels of Vitamin E were significantly lower in all HCV positive patients compared to controls [p<0.001] and were higher in group I [b] compared to group I [a] with statistically significant difference [p<0.000]. Serum levels of MDA showed a highly significant positive correlation with serum levels of ALT in group I [a] [r=0.633; p=0.001]. Both MDA and vitamin E levels are reliable indicators for the extent of oxidative stress and antioxidant status in HCV patients. MDA can be used as a simple non-invasive blood marker for detection of progression of chronic HCV to fibrosis