VALUE OF SERUM ERYTHROPOIETIN LEVEL IN PATIENTS WITH AND WITHOUT ANEMIA ASSOCIATED WITH HEPATITIS C ANTI-VIRAL TREATMENT

Background : Erythropoietin (EPO) is a glycoprotein hormone that regulates red blood cells production (erythropoiesis). It is commonly used in anemia which occurs in approximately 10% up to 30% of patients receiving hepatitis C antiviral therapy. Aim of the study: The aim of this work is to determine the value of serum EPO in patients suffering from HCV concomitant anemia with or without hepatitis C antiviral treatment{pegylated interferon(PEG-INF) and ribavirin (RBV)} to evaluate its role in those patients. Subjects and methods: This study included 75 subjects who were subdivided into the following subgroups; Group ?; 15 non-anemic chronic HCV patients and not receiving anti- viral therapy, Group ??; 15 anemic chronic HCV patients and not receiving anti-viral therapy, Group ???; 15 non-anemic chronic HCV patients and under anti-viral therapy, Group ?V; 15 anemic chronic HCV patients and under anti-viral therapy and Control group; 15 healthy volunteers with matched age and sex. All studied individuals were subjected to detailed history taking, thorough physical examination, abdominal ultrasonography and routine laboratory investigations before combined treatment with peg interferon and ribavirin for HCV. Estimation of EPO in serum was done by IMMULITE. Results: This study revealed that serum EPO level didn\\\'t show significant difference as regards gender (28.54±11.83 in males Vs 29.81±11.44 in females, P-value = 0.68). Statistically significant higher levels of serum EPO was found in patients when compared to controls and in treated patients when compared to untreated patients (P- value < 0.001). The highest levels were found in Group IV, while the lowest levels were found in Group I. Positive correlation was found between serum EPO and Hb% levels in anemic patients (treated or untreated). Conclusion: chronic liver disease by HCV does not affect the physiological erythropoietin response to anemia. Serum EPO level was significantly higher in chronically infected patients with HCV compared with healthy control group. Also, serum EPO level increased in anemic more than non-anemic patients specially when treated with PEG-INF and ribavirin.