- Oral presentation
- Open Access
Inflammatory patterns in patients with chronic hepatitis C
© Munteanu et al; licensee BioMed Central Ltd. 2013
- Published: 16 December 2013
- Liver Fibrosis
- Tumor Necrosis Factor Alpha
- Sustained Virological Response
- Hepatic Stellate Cell
- Fibrosis Score
In patients with chronic hepatitis C (CHC), liver fibrosis is a complex process, not completely understood, resulting from the activation of hepatic stellate cells and a pro-inflammatory status.
We aimed to evaluate the inflammation patterns in patients with CHC and the correlations between the inflammatory biomarkers and liver fibrosis.
We performed a cross-sectional study on patients with CHC, in a tertiary-care hospital in November 2011 – April 2012. We staged liver fibrosis using FibroMax (BioPredictive) and we used CobasTaqman (Roche) for HCV-RNA quantification. Patients were also evaluated by ALT, platelets, erythrocyte sedimentation rate (ESR), fibrinogen, C-reactive protein (CRP) and tumor necrosis factor alpha (TNFa) plasma levels. For TNFa quantification we used Kamiya Biomedical Company ELISA kits.
We enrolled 76 patients with CHC (sex ratio M/F 0.6/1, median age 51 [44-58] years). According to the FibroMax evaluation, most of the patients had F0 fibrosis (25%, n=19), F2 fibrosis (42%, n=32) and F4 fibrosis (16%, n=12) respectively. The median HCV-RNA was 5 [5-5.75] log10. History of previous HCV-therapy with pegIFN and ribavirin was recorded in 75% (n=57) of patients and half of them had a sustained virological response.
The inflammatory biomarkers displayed the following patterns: median ESR 12 [8-22.5] mm/h, median fibrinogen 295 [254-343] mg/dL, median CRP 0.55 [0.2-1.5] mg/L, median TNF alpha 6.38 [4.75-9.33] pg/mL.
Comparing the patients without fibrosis (F0) with the patients with fibrosis (F1-F4), we found a significant difference between TNFa values (patients with F0 - median TNFa 5.5 [4.0-7.1] pg/mL; patients with F1-F4 – median TNFa 7.3 [5.0-10.6]; p<0.001). In patients with fibrosis, we found a moderate correlation between TNFa values and fibrosis score, according to the FibroMax score (rho=0.4, p=0.002) and between TNFa values and ALT (rho=0.43, p=0.001).
In patients with CHC, liver fibrosis is correlated with the levels of TNFa, as a biomarker of systemic inflammation.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.