Vitamins B depletion, lower iron status and decreased antioxidative defense in patients with chronic hepatitis C treated by pegylated interferon alfa and ribavirin.
OBJECTIVE
The impact of pegylated interferon combined with ribavirin upon the status of B vitamins, iron and oxidative stress in patients with hepatitis C virus (HCV) infection was examined.


METHODS
Blood levels of B vitamins, iron status, and oxidative stress associated biomarkers were determined for 152 healthy controls and 109 HCV patients treated by pegylated interferon and ribavirin at three stages: before therapy, week 24 of treatment, and 48 weeks after therapy.


RESULTS
HCV infection significantly lowered vitamin B(6) and folate (p<0.05). Therapy caused further decrease in vitamin B(6) (p<0.05), and also significantly decreased vitamins B(1) and B(2) (p<0.05). This anti-HCV therapy caused more patients to exhibit insufficient iron status. HCV infection elevated plasma level of malondialdehyde and 8-isoprostane, and therapy further exacerbated lipid oxidation (p<0.05). HCV infection significantly lowered vitamin C and glutathione levels (p<0.05); therapy significantly reduced alpha-tocopherol and activity of glutathione peroxidase and superoxide dismutase (p<0.05).


CONCLUSIONS
This anti-HCV therapy elevated oxidative stress and depleted B vitamins and iron. Thus, the supplement of antioxidant agents, B vitamins and/or iron should be considered for patients with this therapy in order to avoid other healthy risk.
Lin
Chun-Che
CC
Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan, ROC.
Yin
Mei-Chin
MC
D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000378:metabolism; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005494:Folic Acid Deficiency / Q000097:blood / Q000453:epidemiology; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use; D007501:Iron / Q000097:blood; D000090463:Iron Deficiencies; D015227:Lipid Peroxidation; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010084:Oxidation-Reduction; D018384:Oxidative Stress; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use; D026681:Vitamin B 6 Deficiency / Q000097:blood / Q000453:epidemiology; D014803:Vitamin B Complex / Q000097:blood*; D014804:Vitamin B Deficiency / Q000097:blood / Q000453:epidemiology*; D055815:Young Adult
D000975:Antioxidants; D000998:Antiviral Agents; D015415:Biomarkers; D016898:Interferon-alpha; D014803:Vitamin B Complex; D012254:Ribavirin; D007501:Iron