The effect of increased oxidative stress and ferritin in reducing the effectiveness of therapy in chronic hepatitis C patients.
ABSTRACT BACKGROUND/AIM: Chronic hepatitis C (CHC) patients have higher oxidative stress and ferritin than healthy individuals. However, the level of oxidative stress in CHC patients during treatment with peginterferon alpha-2a and ribavirin is not clear. The aims of our study are to investigate changes of thiobarbituric acid reactive substances (TBARS; indicated oxidative stress), total antioxidant status (TAS) and ferritin in CHC patients during therapy and to identify the correlation of these factors and the effectiveness of therapy. METHODS: Sixty CHC patients were selected and were prescribed 180μg of peginteferon alpha-2a once a week and a daily dose of 1000 to 1200mg ribavirin for 6months. Throughout the treatment course, blood samples were taken to determine TBARS, TAS, and liver inflammation profiles including ferritin, aspartate transaminase (AST) and alanine transaminase (ALT). RESULTS: The level of TBARS increased before the 12th week of therapy. Additionally, the levels of TBARS were higher in non-rapid virological response (RVR) patients compared with RVR (p<0.01) in baseline and therapy at the 24th week. TAS was lower during therapy than at baseline. Levels of TAS were significantly higher in sustained virological response (SVR) patients than in non-SVR (p<0.01) in the 4th week post-therapy. We also found a positive correlation between the level of ferritin and liver inflammation during treatment (p<0.01). The levels of ferritin and ALT were lower in SVR than in non-SVR patients in the 4th week of post-therapy (p<0.01). CONCLUSIONS: This study indicated that decreased ferritin, decreased TBARS and increased TAS status may improve the efficacy of treatment.