Role of Hepcidin in Anemia of Chronic Hepatitis C Patients

This study was done to clarify the role of hepcidin in the regulation of iron homeostasis and development of anemia in chronic hepatitis C (CHC) patients targeting the differentiation of the type of anemia. Patients and methods: This study was conducted on 70 CHC patients. Iron profile and soluble transferrin receptor (sTfR) were measured. Transferrin saturation and transferrin receptor ferritin (TfR-F) Index were calculated. Serum prohepcidine hormone and IL6 levels were measured (ELISA). Histopathological examination and immunohistochemical detection of hepcidin were done. According to the iron profile patients were reclassified into iron deficiency anemia (IDA) group, anemia of chronic disease group (ACD) and combined anemia group (COMBI). Results: 64.3% of patients were of the COMBI group, 10% had ACD and 25.7% had IDA. Hepcidin was increased in Child C group (P<0.05). Hepatic expression of hepcidin showed reduced expression in Child A, B and C groups. Hepcidin level was found to be increased in ACD and COMBI group in comparison to control and IDA group. Stepwise logistic regression demonstrated that sTfR was the most predictive parameter for IDA while hepcidin was the most predictive parameter for ACD and COMBI in CHC patients. Conclusion: hepcidin plays an important role in the pathogenesis of anemia in CHC patients. The role of hepcidin in discriminating different types of anemia in CLD is comparable to that of sTfR/logFn index. An appropriate combination of both tests provides evidence for iron depletion or reflects excessive production of hepcidin which will help to establish a correct diagnosis of IDA, ACD or combined anemia in patients with CHC. (Journal of American Science. 2010;6(12):145-154). (ISSN: 1545-1003).