Evaluation of Vitamin D and Iron Status in Chronic Hepatitis C Virus Patients Before and After Treatment
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 87
- 主要终点
- change in levels of vitamin D
研究概览
简要总结
HCV is associated with vitamin D deficiency. Iron overload is frequently occurred in chronic hepatitis C patients; more than one third of HCV positive patients have elevated serum iron, ferritin, and transferrin which were linked to bad prognosis. Hepcidin is a regulatory peptide that is mainly synthesized by the liver cells and plays an important role in iron homeostasis. There is an interaction between iron metabolism and vitamin D metabolism. Iron is essential for vitamin D activation and vitamin D deficiency is associated with elevated hepcidin level, which partly accounts for anemia associated with vitamin D deficiency. Up to our knowledge, little is known about the association between vitamin D status and iron metabolism in HCV patients.
详细描述
Hepatitis C virus (HCV) is one of the global public health problems. World Health Organization (WHO) reported that more than 80 million people all over the world are infected with HCV. Approximately 700000 persons die every year from hepatitis C-related complications. Egypt is one of the highest prevalence rates of HCV, worldwide.
Vitamin D possesses anti-inflammatory, anti-oxidant, anti-fibrotic and immunomodulatory effects. HCV is associated with vitamin D deficiency. Liver plays an important role in vitamin D hydroxylation and iron metabolism. It stores iron, synthesizes iron transporting protein (transferrin), iron storage protein (ferritin) and an iron regulatory peptide (hepcidin). Iron overload is frequently occurred in chronic hepatitis C patients. More than one third of HCV positive patients have elevated serum iron, ferritin, and transferrin which were linked to bad prognosis. Excess iron is catalyzed by the rapid Fenton reaction producing hydroxyl radicals from hydrogen peroxide and superoxide (10), which induces lipid peroxidation and cellular damage. Hepcidin is a regulatory peptide that is mainly synthesized by the liver cells and plays an important role in iron homeostasis via inhibiting iron absorption and preventing iron efflux from macrophages and thus prevents normal recycling of the iron needed for erythropoiesis. In addition, hepcidin inhibits HCV replication via activation of STAT3. A reduced serum hepcidin has been reported in chronic HCV patients which was correlated to the severity of liver histopathological changes and related to iron overload in these patients.
There is an interaction between iron metabolism and vitamin D metabolism. Iron is essential for vitamin D activation and vitamin D deficiency is associated with elevated hepcidin level, which partly accounts for anemia associated with vitamin D deficiency. Up to our knowledge, little is known about the association between vitamin D status and iron metabolism in HCV patients.
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Cross Sectional
入排标准
- 年龄范围
- 18 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Naïve HCV Patients (>18Y) coming to National Committee for control of viral hepatitis to receive their treatment
排除标准
- •Age less than 18 years old or more than 70 years old.
- •previously received treatment for HCV
- •Manifestations or history of manifestations of liver cell failure and cirrhosis including ascites and hepatic encephalopathy.
- •Patients co-infected by the hepatitis B (HBV), human immunodeficiency viruses (HIV).
- •Hepatocellular carcinoma and other extra hepatic carcinoma.
- •Renal disease.
- •Patients receiving vitamin D, calcium therapy or iron supplementation for the last 3 months will be excluded.
- •Total serum bilirubin ≥ 3 mg/dl.
- •Serum albumin < 2.8 g/dl
- •international normalization ratio (INR)> 1.7
- •Platelet count <50000/mm3
- •Serum creatinine >2.5mg/l
研究组 & 干预措施
hepatitis C-ttt
Naïve HCV Patients (>18Y) coming to National Committee for control of viral hepatitis- 12 weeks after stoppage their treatment of sofosbuvir 400 mg/day plus Daclatasvir 60 mg/day for 12 weeks.
干预措施: Sofosbuvir 400 mg (Drug)
hepatitis C-ttt
Naïve HCV Patients (>18Y) coming to National Committee for control of viral hepatitis- 12 weeks after stoppage their treatment of sofosbuvir 400 mg/day plus Daclatasvir 60 mg/day for 12 weeks.
干预措施: Daclatasvir 60 mg/day (Drug)
结局指标
主要结局
change in levels of vitamin D
时间窗: 6 months
Serum vitamin D (25OH vitamin D) before starting the treatment and after 6 months
Change in iron level
时间窗: 6 months
Serum iron level before treatment and after 6 months
Change in total iron binding capacity
时间窗: 6 month
Serum total iron binding capacity before starting the treatment and after 6 months
Change in serum hepcidin
时间窗: 6 months
Serum hepcidin before starting the treatment and after 6 months
次要结局
- correlate levels of vitamin D, iron, total iron binding capacity and hepcidin with sustain virologic response or any complications(one day)
研究者
Eman Sayed Hassan Abd Allah
principle investigator, assistant professor of Medical Physiology
Assiut University