Effect of hepatobiliary disease, chronic hepatitis C and hepatitis B virusinfections and interferon-alpha on porphyrin profiles in plasma, urine andfaeces

Background: Documentation of the profiles of porphyrins in hepatobiliary di sease is limited. Strong associations of hepatitis B and C virus infections with porphyria cutanea tarda have suggested causal relationships. This stu dy aimed to determine the nature of porphyrin abnormalities in hepatobiliar y disease and the effect of interferon-alpha on porphyrin profiles. Methods: Total porphyrins were measured in the plasma, urine and faeces of 83 patients with hepatobiliary disease (37 hepatitis C, 20 hepatitis B, 26 other causes) and 12 clinical controls, and porphyrin profiles were determi ned by high-performance liquid chromatography. Results: Porphyrins were elevated in the plasma of 11 and urine of 23 patie nts with hepatobiliary disease, as a result of elevated coproporphyrin I. T his was reflected in increased coproporphyrin I:III ratios. Abnormal total porphyrin levels had a significant negative correlation with plasma albumin , and a positive correlation with bilirubin and alkaline phosphatase, but n ot with aminotransferases. Total urinary porphyrins were elevated in three control patients, but coproporphyrin I:III ratios were normal. Although not seen in plasma or urine, porphyrins that are specific for porphyria cutane a tarda were found in the faeces of six patients, but this occurred with si milar frequency in hepatitis B or C infection (four of 50) as in the clinic al controls (two of 12). Interferon-alpha had no effect during or after the rapy in six patients with hepatitis C. Conclusions: Reduced biliary excretion of coproporphyrin I occurs in more s evere cholestasis and/or hepatic dysfunction. A causal relationship between viral liver disease and porphyria cutanea tarda which is unlikely to be pr ecipitated by interferon-alpha, is not supported. (C) 2000 Blackwell Scienc e Asia Pty Ltd.