A Study of Changes in Prohepcidin and Iron Levels in Patients with Liver Transplant and Chronic Viral Hepatitis

Abstract

Aim:To study changes in hepcidin, a key protein synthesized in the liver, following chronic viral hepatitis, cirrhosis and/or liver transplant, as well as the effect of hepcidin level variation on liver function tests and iron levels.Materials and Methods:The patient population was distributed as follows: Group 1: inactive chronic hepatitis B (n=31); Group 2: chronic hepatitis C (n=30); Group 3: decompensated cirrhosis linked to hepatitis C virus (HCV) or hepatitis B virus (HBV) (n=29); Group 4: decompensated HCV- or HBV-related cirrhosis treated by liver transplantation (n=31).Results:The following characteristics were unequally distributed among the groups: age, Hb, AST, ALP, LDH, T. bil, albumin, total cholesterol, HDL, serum total iron binding capacity, and transferrin saturation (TS). In the two-group comparison of Groups 1 and 2, significant differences in Hb, AST, AP, albumin, and prohepcidin were observed; the latter was more elevated in HCV patients (Group 2) (p<0.05). Comparison between Groups 3 and 4 yielded significant differences in Hb, AST, LDH, T. bil, albumin, total cholesterol, serum iron, and TS. Prohepcidin was most elevated in Group 2. Prohepcidin level was positively correlated with ferritin and negatively with albumin and Hb in all study groups. The highest concentration of ferritin was encountered in Group 4 patients, who had undergone liver transplant, followed in decreasing order by Group 3, Group 2 and Group 1; however, no statistically significant difference could be established (p=0.052).Conclusion:In our study, a significantly positive correlation between AST/ALT and prohepcidin levels in patients who had liver transplantation caused by HBV or HCV was established. This finding may be an indicator of inflammation after transplantation.

Keywords

• liver transplant
• chronic viral hepatitis
• prohepcidin