ASSESSMENT OF SERUM LEVEL OF ERYTHROPOIETIN AND ANTI-ERYTHROPOIETIN ANTIBODY IN CHRONIC HEPATITIS C VIRUS INFECTED PATIENTS WITH CHRONIC ANEMIA

Background and Aims: Circulating erythropoietin (Epo) levels were found to be increased in patients with acute and chronic liver diseases. The aim of the present study was to evaluate the level of plasma erythropoietin and anti-erythropoietin antibodies levels in patients suffering from HCV positive chronic liver disease with chronic anemia in order to assess the relationship between serum erythropoietin and anti-erythropoietin antibodies and hemoglobin concentration as an indicator of the activity of bone marrow erythropoiesis Methods: Thestudy group:comprised (60) chronic HCV infected anaemic patients they were subdivided into three subgroups according to Child-Pugh classification: Child A: comprised (20) patients (Childs grade A) Child B: comprised (20) patients (Childs grade B) Child C: comprised (20) patients (Childs grade C) The control group: comprised (20) non anemic chronic HCV infected patients as controls. Plasma Epo anti-erythropoietin antibodies was detected to all subjects. Results: a positive correlation of plasma EPO levels to the severity of liver diseases, HCV infected patients with anemia had higher plasma levels of EPO than those without anemia a highly significant negative correlation between mean Hb concentration and mean plasma EPO values, positive correlation between serum erythropoietin and serum ferritin (r = 0.2, p < 0.001), (7) patients showed anti-EPO antibodies positivity all were included among the Child–Pugh C. Conclusion: Plasma Epo levels are significantly higher in anemic HCV infected patients than that of non anemic HCV patients and High serum ferritin with anaemia indicates failure of iron utilization during the process of erythropoiesis which constitutes the major iron utilisation pool in the body which could be due to irresponsiveness of the early erythroid proginators to the increased continous erythropoietin stimulation.