Endothelial Dysfunction in Patients with Chronic HCV Infection

Hepatitis C virus (HCV) infection is associated with in-flammation of liver endothelium, which contributes to the pathogenesis of chronic hepatitis. Purpose: To assess the value of von Willebrand factor (vWf) level in patients with HCV infection, as a marker of endothelial dysfunction and an indicator of progression, severity and morbidity of chronic liver disease. And its relation to the HCV load as measured by the HCV RNA PCR. Methods: The study included 55 subjects: 45 positive for HCV and 10 controls, negative for HCV by assessment of quantitative HCV RNA PCR. Liver function tests including liver transaminases, bilirubin, prothrombin concentration, and serum albumin were assessed, as well as kidney functions tests, complete blood count and serum sodium and potassium. vWf antigen assay was done for all subjects by ELISA technique. Child Puph staging score was evaluated for every patient. Results: The mean vWf levels were higher in HCV patients than normal subjects (146±55.46, 97.14±56.32, p 0.035). Morever vWf levels showed a significant positive correlation with liver AST ALT total bilirubin, and Child Puph staging score and a significant negative correlation with prothrombin con-centration. However quantitative HCV RNA PCR showed no correlation with vWf levels nor with the liver function tests. Conclusions: Chronic HCV infection is associated with endothelial dysfunction as judged by vWf levels, especially in advanced liver disease. vWf levels had a significant rising trend on deterioration of liver functions independent on the HCV viral load.