Estimation of Serum Leptin Level in Egyptian Patients With Chronic HCV After Antiviral Treatment

Abstract

Hepatitis C virus usually causes chronic infection, which can result in chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. Mediator factors named adipocytokines influence metabolic alterations (i.e. insulin resistance) as well as hepatocellular damage. Among them leptin seems to play important role in pathogenesis of liver damage. Aim: We aimed in this study to evaluate the potential prognostic value of serum leptin in chronic hepatitis C patients under interferon therapy. Methods: A prospective study was performed in 90 patients with chronic hepatitis C treated with IFN and weight based ribavirin from January 2012 to May 2014. Sustained response was defined as negative by hepatitis C virus RNA analysis using PCR at 24 weeks after cessation of IFN therapy. Non responders, who were positive to HCV RNA at the end of 12 weeks of treatment. Serum leptin was assessed using EI A. Results: Sustained response was achieved in 52 patients (58%). Overall, the factors associated with sustained antiviral effects were HCV-RNA load, serum leptin level, and stage of liver fibrosis evaluated by univariate analysis. BMI was not associated with any therapeutic effect of IFN. Multivariate analysis indicated that HCV-RNA load was a significant risk factor and leptin level was an independent risk factor for IFN resistance. Namely, a high level of serum leptin attenuated the effect of IFN in patients with chronic hepatitis C. Conclusion: High serum leptin level is a negative predictor of response to antiviral treatment in chronic hepatitis C. In chronic hepatitis C patients, we considered serum leptin level ≤7ng/mL is a predictor of sustained virological response.