Disease severity and erythropoiesis in chronic hepatitis C

作者：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^*

来源：Journal of Gastroenterology and Hepatology, 2017, 32(4): 864-869.

DOI：10.1111/jgh.13600

• CHC
• EPO
• fibrosis
• HCV

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 (1.440.36 log mIU/mL versus 1.03 +/- 0.31 log mIU/mL, P<0.0001) and lower hemoglobin (Hb) concentrations (14.6 +/- 1.4g/dL versus 15.3 +/- 1.2g/dL, P<0.001) as compared with healthy controls. Among the CHC patients, the serum EPO level was negatively associated with the Hb concentration (=-0.227; 95% confidence intervals [CI]: -0.09-0.027; P<0.001) and RBC counts (=-0.204; 95% CI: -0.245-0.061; P=0.001) and was positively correlated with necroinflammatory activity (=0.201; 95% CI: 0.009-0.046; P=0.003) and fibrosis (=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 (=0.214; 95% CI: 0.046-0.209, P=0.002), whereas the Hb concentration was inversely (=-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.

• 出版日期2017-4
• 单位中山大学