Autor(es): Ferreira, Joana ; Faustino, Paula ; Bicho, Manuel ; Serejo, Fátima
Data: 2023
Identificador Persistente: http://hdl.handle.net/10400.18/9145
Origem: Repositório Científico do Instituto Nacional de Saúde
Assunto(s): Doenças Genéticas; Modificadores genéticos; Metabolismo do ferro; Hepatite C; DAA; Fibrose do fígado; HFE; ISAMB; Hepatitis C; Virus infection; Iron Metabolism; Liver Fibrosis; Direct Acting Antivirals (DAAs)
Introduction: Chronic Hepatitis C (CHC) is characterized by hepatic and extra-hepatic manifestation. Among hepatic manifestations, liver fibrosis is probably the most significant as it can lead to cirrhosis, hepatocellular carcinoma and death. Iron overload is one of the extra-hepatic manifestations induced by Hepatitis C Virus (HCV) infection and can induce fibrosis-promoting signals in the parenchymal and non-parenchymal cells, which accelerate disease progression and exacerbate liver pathology. Aims: Evaluate the changes in iron metabolism induced by HCV elimination, the association of liver fibrosis with biochemical and genetic parameters of iron metabolism before and after DAAs treatment and baseline parameters that could predict the improvement of liver fibrosis after treatment. Materials and Methods: 329 patients with CHC (age: 49.93 [45.57-50.28] years; 124 female and 205 male). 134 treated with DAAs with sustained response (age: 53.42 [51.47-55.36]; 58 female and 56 male). Liver fibrosis stage was assessed by transient elastography using a Fibroscan and patients were divided in two groups (F1/2_mild and moderate fibrosis and F3/4_severe fibrosis and cirrhosis), biochemical parameters of iron metabolism (Total Iron_Fe, Total Iron Binding Capacity_TIBC, Transferrin Saturation_TS, Ferritin_FT, Haptoglobin_Hp) were evaluated by standard methods and genetic polymorphisms within Transferrin_TF HFE, Bone Morphogenetic Protein 2_BMP2, Hepcidin_HAMP and Ferroportin_SLC40A1 genes were analyzed by PCR, sequencing or NGS. Statistical analysis was performed using SPSS 26.0 for windows. Results: Patients showed lower values of Fe, TS and FT and higher values of Hp after treatment.
