Study of erythropoeitin on IGM serum levels in HCV positive patients on regular HD

ABSTRACT

Both uremia and HD process cause immunosuppression in HD patients. There was significant increase of total serum IgG and IgM levels found in patients with chronic HCV compared with healthy controls. There is evidence pointing to direct effect of rHuEPO upon B cells. High doses of recombinant human erythropoietin [rHu EPO] enhanced in vitro Ig production and proliferation of various plasma cell lines, as well as human plasma cells generated in vitro. Study was conducted at hemodialysis Unit of Shubra Municipal hospital between August 2010 to February 2011. 30 HCV positive patients on regular hemodialysis were included in study, using bicarbonate dialysate and polysulfone membrane dialyser, for 4 hours 3 times weekly. Patients were divided into 2 groups first group 15 patients on EPO therapy. 4000 IU/week and second group not taking EPO for all patients full clinical examination was done, CBC, BUN, serum creatinine, ALT, AST, serum albumin and serum IgM by ELISA [quantitative assay], were done. There was no significant difference between 2 groups as regards age, sex distribution, WBC count, ALT, AST, serum creatinine, BUN and IgM serum level. First group had borderline significant higher Hgb and Hct than second group [p = 0.056]. Females didn't have higher serum IgM level than males [p = 0.403]. All correlations of IgM serum level to other parameters of study were irrelevant. Uremia seems to protect ESRD patients on regular HD from complications of HCV and also EPO effect on Ig serum levels