title: Oxidative stress in chronic hepatitis C: not just a feature of late stage disease.
abstract: OBJECTIVE
  Chronic hepatitis C infection is a major world-wide problem, frequently progressing to cirrhosis, liver failure or hepatoma. The pathological mechanisms of disease progression are unclear but oxidant stress may play a role.
  
  
  METHODS
  Markers of lipid peroxidation, antioxidant status, hepatic fibrogenesis and liver function were measured in blood or urine from 42 chronic hepatitis C patients. Fibrosis was graded histologically in a subgroup of 33 patients.
  
  
  RESULTS
  The lipid peroxidation marker 8-isoprostane and the ratio of oxidized to reduced glutathione were significantly elevated (P<0.001, P=0.006). The antioxidants glutathione, selenium and vitamins A, C and E were significantly decreased (all P<0.001) compared to age and sex matched controls. Abnormal values were more marked in cirrhotics, but significant changes were also observed in the non-cirrhotic group. The fibrosis score correlated positively with urinary 8-isoprostane and type III procollagen peptide and negatively with vitamin A.
  
  
  CONCLUSIONS
  Oxidant stress, as reflected in blood and urine by a wide range of pro- and antioxidant markers, is a significant feature of hepatitis C infection. Although more severe in the cirrhotic group, there was clear evidence of oxidant stress in non-cirrhotic patients. Antioxidant therapy may therefore have a role in slowing disease progression to cirrhosis.
authors.affiliation: The Liver Unit, Manchester Royal Infirmary, Manchester, UK.
authors.forename: Sanjiv K
authors.initials: SK
authors.lastname: Jain
authors.forename: Philip W
authors.initials: PW
authors.lastname: Pemberton
authors.forename: Alexander
authors.initials: A
authors.lastname: Smith
authors.forename: Raymond F T
authors.initials: RF
authors.lastname: McMahon
authors.forename: Peter C
authors.initials: PC
authors.lastname: Burrows
authors.forename: Ali
authors.initials: A
authors.lastname: Aboutwerat
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Warnes
mesh_terms: D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000378:metabolism; D001205:Ascorbic Acid / Q000378:metabolism; D015237:Dinoprost / Q000031:analogs & derivatives*; D028441:F2-Isoprostanes / Q000378:metabolism; D005260:Female; D005978:Glutathione / Q000378:metabolism; D019698:Hepatitis C, Chronic / Q000378:metabolism*; D006801:Humans; D015227:Lipid Peroxidation; D008103:Liver Cirrhosis / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D012643:Selenium / Q000378:metabolism; D014801:Vitamin A / Q000378:metabolism; D014810:Vitamin E / Q000378:metabolism
chemical_list: D000975:Antioxidants; D028441:F2-Isoprostanes; D014801:Vitamin A; D014810:Vitamin E; C075750:8-epi-prostaglandin F2alpha; D015237:Dinoprost; D005978:Glutathione; D012643:Selenium; D001205:Ascorbic Acid