Molecular study of hepcidin in chronic hepatitis C genotype 4 patients treated with pegylated interferon/ribavirin with vitamin D

Introduction: We aimed to find out an association between hepcidin and chronic hepatitis C virus (HCV) patients treated with pegylated interferon-α/ribavirin (PEG-IFN-α/RBV) with vitamin D supplements. Patients and methods: Seventy-three chronic HCV patients who were enrolled in the study received the standard of care therapy consisting of PEG-IFN/RBV+vitamin D3. All patients were subjected to vitamin D and hepcidin level assessment and HCV RNA detection using quantitative reverse transcription PCR for 48 weeks of treatment. Results: We classified our patients retrograde into responders and nonresponders to PEG-IFN-α2b+RBV therapy. Among responders, the mean level of vitamin D after therapy was 65.48 versus 9.30 ng/ml among nonresponders. Among responders, serum hepcidin, serum ferritin, and hepcidin/ferritin ratio were significantly elevated (P 0.001, 0.001, and P=0.036, respectively) after vitamin D therapy compared with nonresponders (P=0.06, 0.76, and 0.428, respectively). There was a significant increase in hepcidin, ferritin, hepcidin/ferritin ratio in responders compared with nonresponders after treatment (P 0.001, 0.001, and P=0.05, respectively). There was a negative correlation between hepcidin and vitamin D in responders, with a statistically significant difference (r=−0.977 and P 0.001) compared with nonresponders (r=0.367 and P=0.046). Conclusion: In naive patients infected with HCV genotype 4, treatment with interferon α2b and ribavirin and vitamin D3 significantly increased the rate of viral response. No correlation was found between hepcidin expression, hepcidin serum level, and vitamin D level before start of therapy.