ANTIPYRINE CLEARANCE AND METABOLITE EXCRETION IN PATIENTS WITH CHRONIC HEPATITIS-C

Background/Aims: Our aim was to study whether chronic hepatitis C affe cts the three metabolic pathways of the model drug antipyrine differen tly. Methods: We measured antipyrine clearance from saliva as well as urinary excretion of its main metabolites 4-hydroxy-antipyrine, 3-hydr oxy-methyl-antipyrine, and nor-antipyrine in 24 patients with chronic hepatitis C and in 21 healthy control subjects. Due to incomplete urin e collection, 12 liver patients and three controls were excluded. Resu lts: Antipyrine clearance (mean+/-SD) was significantly lower in patie nts with chronic hepatitis C, 1.2+/-0.7 l.h(-1) (n=12), than in contro ls (n=18), 2.2+/-1.0 l.h(-1) (p=0.006), The urinary excretion of each of the metabolites was depressed to an equal extent in liver patients, The severity of the liver disease, as assessed by Child Pugh score, s erum albumin and bilirubin, correlated significantly with antipyrine c learance and urinary excretion of the metabolite 3-hydroxy-methyl-anti pyrine . The hepatitis activity index (Knodell) correlated with 3-hydr oxy-methyl-antipyrine and 4-hydroxy-antipyrine, only. Conclusions: Mod erate-severe chronic hepatitis C does not seem to depress the three ma in metabolic pathways of antipyrine differently.