Journal of Babylon University/Pure and Applied Sciences/ No.(2)/ Vol.(21): 2013
Used Of Some Physiological Parameters In
Prediction Of Chronic Hepatitis C Disease
Mohammad Hussein obaid
University of Babylon- College of Science-Biology Department
Abstract
An physiological study has been done for patients with hepatitis c .Levels of Ferritin,alkaline
phosphate,Glutamyl oxaloacetic transminase(GOT) and Glutamyl pyruvic transminase(GPT) in sera for
30 patients and 10 healthy subjects were determined . The results showed increased in levels of
Ferritin,alkaline phosphate,GPT,and GOT compared with control group.These results suggested that
increases values of Ferritin and other parameters may be a maeker of chronic hepatitis c infection.
Keys: Hepatitis c, Ferritin ,HC Virus .
‫الخالصة‬
Ferritin,alkaline ‫ وذلك بتحديد مستويات‬,‫ المزمن‬C ‫تم عمل دراسه فسلجيه للمرضى المصابين بالتهاب الكبد الفايروسي نمط‬
‫ في مصل‬phosphate,Glutamyl oxaloacetic transminase(GOT) and Glutamyl pyruvic transminase(GPT)
Ferritin,alkaline
‫بينت الدراسة ان هنالك زيادة في مستويات كال من‬. ‫ثالثين مريض مع عشرة اشخاص اصحاء‬
‫ مقارنة مع‬phosphate,Glutamyl oxaloacetic transminase(GOT) and Glutamyl pyruvic transminase(GPT)
‫ وقد اقترحت هذه النتائج ان قيم الزيادات في مستويات الفريتين والمعايير االخرى ربما تكون مؤشر لالصابة بالتهاب‬. ‫مجموعة السيطرة‬
. ‫ المزمن‬C ‫الكبد الفايروسي نمط‬
Introduction
Hepatitis C is a disease affecting the liver of patients (Ryan and Ray
2004;Reddy,2010).The infection by hepatitis C virus cause chronic infection can lead
to asymptomatic often which is cirrhosis and advanced scarring (fibrosis scarring of
the liver) generally apparent after many years . In some cases, those with cirrhosis
will go on to develop liver failure or other complications of cirrhosis(Ryan and Ray
2004). Hepatitis infection usually progresses in a predictable and slow fashion about
six weeks after exposure to the virus, peoples undergo the acute phase of infection
,and this stage of illness is usually dismissed by the patients because it passes with
very few, if any, signs or symptoms, therefore, the body has usually not even begun to
produce antibodies specific to the virus, so a blood test may not reveal clues to
infection (Iwasaki. et al.,2002) .
Reduction of iron in sera has been shown to normalize liver enzyme levels, which
are elevated during periods of active liver damage (Fong et al 1998). Iron depletion
therapy has also been shown to improve the response to conventional medicines used
to treat hepatitis. The effective way to decrease iron of sera is to have an iron loss, as
occurs when donating blood. Hepatitis C patients cannot donate blood for common
use, but their blood can still be removed, although it must be discarded (Fargion,et al
1997). Ferritin is a protein found inside cells that stores iron so our body can use it
later. A ferritin test indirectly measures the amount of iron in blood (Hoffman .et al.,
2005; McPherson and Pincus.,2007) . The aims of this study was to evaluate a
possible relationship between Ferritin as well as certain parameters and infection with
hepatitis C
.
- 394 -
Material and Methods
1-Blood samples:
Thirty a dult patients (18 male and 12 female),their ages ranged between 19-50
years ,were prediagnostic by physician in AL-Hilla teaching hospital .Ten adult
healthy subject(4 male and 6 female)served as control group.Blood samples were
taken at the hospital laboratory and each sample was subjected to centrifugation , The
sera were immediately stored at deep freez unit.
2-Tests:
A-Ferritin test:
This test was done according to Tietz (1999)by using ELISA kit(monobind company).
B-GOT and GPT test:
The Got and Gpt levels were measured according to Reitman and Frankel (1957)
C-Phosphate alkaline test:
This test was done according to Belfeild and Gold berg (1971) by using phosphate
alkaline kit (Biomerieux company).
3-Statistical Analysis:
The results of this work were analyzed using completely randomized
design(Donald,1989).
Results
All sera samples in test group showed elevated in levels of Ferritin and alkaline
phosphatase compared with control group ( Table 1) .
(Table 1) Mean of Ferritin & alkaline phosphatase concentration
Parameters
Samples
pa
Ferritin(ng /ml)
Means ± S.d
Patients (30 )
118 ±14.90
Alkaline phosphatase (U
/ l)
Means ± S.d
144 ±3.87
Control (10 )
51 ± 1
86 ± 0
Standard deveation = S.d *
Table( 2 ) showed increased in levels of Got and Gpt in patients , which reached 35.48
and 43.8 IU/ ml respectively , while it was 14.7 and 23.5 IU/ ml in control group
consecutively.
(Table 2 ) Mean of Liver enzymes (GOT&GPT) Concentration
Parameters
GOT(iu / ml)
Means ± S.d
GPT(iu / ml)
Means ± S.d
Patients (30 )
35.48±2.86
43.8± 0
Control (10 )
14.7± 0
23.5± 0
Samples
- 395 -
Journal of Babylon University/Pure and Applied Sciences/ No.(2)/ Vol.(21): 2013
Discussion
Ferritin is a protein in the body that binds to iron; most of the iron stored in the
body is bound to ferritin. Ferritin is found in the liver, spleen , skeletal muscles, and
bone marrow. Only a small amount of it is found in the blood which shows how much
iron is stored in ours body (Fargion. S. et al., 1997).
The results (tables 1&2)
showed increased levels this parameter of patients group more than the healthy group
which showed normal levels and this agreed with (Di Bisceglie. et al., 1992; Haque.
et al ., 1996; Fargion.et al., 1997; Ganne-Carrie. et al ., 2000; Kakizaki S.et al., 2000)
who founded that Hepatitis C virus infection is significantly associated with increased
serum levels of ferritin and iron and these values were directly correlated with serum
concentrations of GOT, GPT, and γ-glutamyl- transpeptidase.
In medicine, the presence of elevated transaminases, commonly the transaminases
alanine transaminase (GPT) and aspartate transaminase (GOT), may be an indicator of
liver damage (Giboney. 2005). Therefore, we measured the levels of GOT & GPT and
the results revealed increases in GOT &GPT serum levels in patients group compared
with control group,and this result agreed with (Halfon. et al ., 2008 ) who found that
GOT and GPT increased in patients with chronic hepatitis C disease. Elevated serum
(GOT), a liver enzyme that rises in response to increased oxidative stress in the liver
(Iwasaki M et al 2002).
References
Belfield ,A.and Goldberg , (1971). Revised assay for serum phenyl phosphatase
activity using 4- amino – antipyrine enzyme .12: 561- 573.
Di Bisceglie; Axiotis Hoofnagle J.H,and Bacon.( 1992) . Measurements of iron status
in patients with chronic hepatitis. Gastroenterology; 102: 2108-13.
Donald ,.(1989). Multivariant statistical method . 2nd ed. ,university of Pennsylvania
,USA.
Fargion Fracanzani.;and Bacon.( 1997 ) Liver iron influences the response to
interferon alpha therapy in chronic hepatitis C. Eur J Gastroenterol Hepatol.
May;9(5):497–503.
Fong T.L.; Han Hoofnagle J.H; and Chastang C..( 1998 ) A pilot randomized,
controlled trial of the effect of iron depletion on long-term response to alphainterferon in patients with chronic hepatitis Hepatol. Mar;28(3):369–74.
Ganne-Carrie Christidis Chastang and Poynard T. ( 2000 ) Liver iron is predictive of
death in alcoholic cirrhosis: a multivariate study of 229 consecutive patients with
alcoholic and/or hepatitis C virus cirrhosis: a prospective follow up study. Gut; 46:
277-82.
Halfon Munteanu.;and Poynard. (2008). "FibroTest-ActiTest as a non-invasive
marker of liver fibrosis". Gastro. Clin. Biol. 32 (6 Suppl 1): 22–39.
Haque Chandra Gerber and Lok AS.(1996) Iron overload in patients with chronic
hepatitis C: a clinicopathologic study. Hum. Pathol. 27: 1277-81.
Hoffman Benz, Shattil and Munteanu.( 2005 ). Hematology: Basic Principles and
Practice. 4th ed. Philadelphia, Pa: Churchill Livingston;:482.
Iwasaki Kanda.;and Pincus.( 2002 ) Absence of specific symptoms in chronic
hepatitis Gastro. 37(9):709–16.
Kakizaki Takagi Horiguchi N.; and Kanda D .(2000). Iron enhances hepatitis C virus
Replication in cultured human hepatocytes. Liver . 20: 125-8.
McPherson. and Pincus.( 2007 ) Henry's Clinical Diagnosis and Management by
Laboratory Methods. 21st ed. Philadelphia , Pa: WB Saunders:78.
- 396 -
Reddy, K.R. (2010). Microbiology &Parasitology .4th ed. Paras Medical Puplisher.
New Delhi.
Reitman,S.,and Frankel, S.(1957) . clin . path. 28: 56.
Ryan K.J.and Ray C.G. (2004). Sherris Medical Microbiology (4th ed.). McGraw
Hill. pp. 551–2.
Tietz, Burtis, Ashwood, E.R. and Saunders, (1999). Text Book Of Clinical Chemistry
.3rd Ed. 477-530.
Giboney P.T. (2005). "Mildly elevated liver transaminase levels in the asymptomatic
patient". Am Fam Physician 71 (6): 1105–10.
- 397 -