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接受抗病毒治疗的丙肝患者维生素水平降低

作者:
中国台湾中山医科大学附属医院检测109例丙型肝炎病毒(HCV)患者在治疗前、接受聚乙二醇干扰素联合利巴韦林治疗48周后血中B族维生素、铁及机体氧化应激水平,并与152名健康成人对照。结果显示,HCV感染显著降低患者维生素B6及叶酸含量,联合治疗可进一步降低维生素B6水平,显著降低维生素B1、B2水平,并导致患者缺铁。HCV感染显著降低患者体内维生素C和谷胱甘肽水平,联合治疗显著降低α-维生素E水平,并降低谷胱甘肽过氧化物酶活性。论文发表于《临床营养学》(Clinical Nutrition)。

Clin Nutr. 2009 Feb;28(1):34-8.

Vitamins B depletion, lower iron status and decreased antioxidative defense in patients with chronic hepatitis C treated by pegylated interferon alfa and ribavirin.

Lin CC, Yin MC.

Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan, ROC.


BACKGROUND & AIMS: The impact of pegylated interferon combined with ribavirin upon the status of B vitamins, iron and oxidative stress in patients with hepatitis C virus (HCV) infection was examined. METHODS: Blood levels of B vitamins, iron status, and oxidative stress associated biomarkers were determined for 152 healthy controls and 109 HCV patients treated by pegylated interferon and ribavirin at three stages: before therapy, week 24 of treatment, and 48 weeks after therapy. RESULTS: HCV infection significantly lowered vitamin B(6) and folate (p<0.05). Therapy caused further decrease in vitamin B(6) (p<0.05), and also significantly decreased vitamins B(1) and B(2) (p<0.05). This anti-HCV therapy caused more patients to exhibit insufficient iron status. HCV infection elevated plasma level of malondialdehyde and 8-isoprostane, and therapy further exacerbated lipid oxidation (p<0.05). HCV infection significantly lowered vitamin C and glutathione levels (p<0.05); therapy significantly reduced alpha-tocopherol and activity of glutathione peroxidase and superoxide dismutase (p<0.05). CONCLUSION: This anti-HCV therapy elevated oxidative stress and depleted B vitamins and iron. Thus, the supplement of antioxidant agents, B vitamins and/or iron should be considered for patients with this therapy in order to avoid other healthy risk.