Disease severity and erythropoiesis in chronic hepatitis C. Issue 4 (April 2017)

• Record Type: Journal Article
• Authors: Huang, Chung‐Feng; Huang, Ching‐I; Yeh, Ming‐Lun; Hou, Chen; Hou, Nai‐Jen; Hsieh, Ming‐Yen; Huang, Jee‐Fu; Chen, Shinn‐Cherng; Lin, Zu‐Yau; Dai, Chia‐Yen; Chuang, Wan‐Long; Yu, Ming‐Lung
• Is Part Of: Journal of gastroenterology and hepatology. Volume 32:Issue 4(2017)
• Page Start: 864
• Page End: 869
• Publication Date: 2017-04
• Subjects: CHC -- EPO -- fibrosis -- HCV; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.13600
• Languages: English
• ISSNs: 0815-9319

Abstract

Abstract: Background/Aims: The erythropoiesis in hepatitis C virus infection is unclear. We aimed to evaluate the erythropoietic components in chronic hepatitis C (CHC) patients. Methods: The red blood cell (RBC) components, serum erythropoietin (EPO) levels, and their relationship to clinical characteristics were evaluated between 124 age‐matched and sex‐matched healthy controls and 248 histology‐proven CHC patients. Results: Chronic hepatitis C patients had significantly higher serum levels of EPO (1.44 ± 0.36 log mIU/mL versus 1.03 ± 0.31 log mIU/mL, P < 0.0001) and lower hemoglobin (Hb) concentrations (14.6 ± 1.4 g/dL versus 15.3 ± 1.2 g/dL, P < 0.001) as compared with healthy controls. Among the CHC patients, the serum EPO level was negatively associated with the Hb concentration (β = −0.227; 95% confidence intervals [CI]: −0.09–0.027; P < 0.001) and RBC counts (β = −0.204; 95% CI: −0.245–0.061; P = 0.001) and was positively correlated with necroinflammatory activity (β = 0.201; 95% CI: 0.009–0.046; P = 0.003) and fibrosis (β = 0.143; 95% CI: 0.003–0.076; P = 0.04) of liver histopathology. For non‐cirrhotic CHC patients, the severity of liver necroinflammatory activity was positively correlated with the reticulocyte and serum EPO levels ( P = 0.001 and 0.008, respectively), and negatively related to the RBC counts ( P = 0.03). Using stepwise multivariate linear regression analysis, the grade of necroinflammatory activity was positive (β = 0.214; 95% CI: 0.046–0.209, P = 0.002), whereas the Hb concentration was inversely (β = −0.205; 95% CI: −0.09–0.018, P = 0.004) associated with the serum EPO levels in CHC patients. Conclusions: The disease activity in CHC patients had a negative impact on erythropoiesis with compensatory higher but blunted EPO responses.