Abnormal uroporphyrin levels in chronic hepatitis C virus infection

A strong association between hepatitis C virus (HCV) infection and porphyri a cutanea tarda (PCT) has been observed, but the implications of the viral infection in the metabolism of porphyrins in patients without clinical mani festations of PCT are not known. The levels of porphyrin in plasma and urop orphyrin (URO) and coproporphyrin (COPRO) in 24-hour urine were measured in 156 patients with chronic HCV infection showing no clinical evidence of PC T. Levels of URO higher than the upper limit were observed in 35 of 156 pat ients (22.4%). The range and the mean values +/- standard deviation were 26 -1, 196 mu g/24 hours and 82 +/- 204 mu g/24 hours. Increased levels of COP RO and plasma porphyrin were observed in 12 of 156 patients (7.7%) and 2 of 156 patients (1.3%) respectively. There were no differences between patien ts with increased URO levels and patients with normal URO levels in terms o f gender, age, risk factors for HCV infection, alcohol abuse, or hepatitis B viral infection. Transferrin saturation (p = 0.040), gamma glutamyl trans peptidase (P < 0.0001), aspartate aminotransferase (P = 0.006), and alanine aminotransferase (P = 0.040) were significantly higher in patients with ab normal URO than in patients with normal URO. The frequency of cirrhosis was higher, but not significantly different, in patients with increased URO (1 6.7%) compared with patients with nor mal URO (3.5%). The authors demonstra ted that even without a clinical manifestation of PCT it is possible to det ect abnormalities in the metabolism of porphyrins in patients with chronic HCV infection. The implications of these findings deserve additional invest igation.