Avaliação do estresse oxidativo em portadores de hepatite c que fazem uso da terapia combinada com interferon alfa peguillado e ribavirina

Abstract

Viral hepatitis is currently a relevant public health issue in Brazil and the world; it is ubiquitous, reaching several segments of the population and causing severe morbidity and mortality. The standard treatment for viral hepatitis C during the last few decades has been combination therapy with alpha-pegylated interferon (PEG-IFN) and ribavirin (RBV), a guanosine analog that disrupts viral RNA metabolism. The treatment of chronic forms is based on this combination of drugs, for a period of 24–48 weeks, depending on the viral genotype found. Hepatitis C has a high impact on global public health. Recent studies suggest the involvement of oxidative stress in the pathogenesis of hepatitis C and hepatocellular carcinoma. Oxidative cellular damage plays an important role in the pathophysiology of hepatitis C virus (HCV). Oxidative stress is triggered when the concentration of oxygen species in the extracellular or intracellular environment exceeds the capacity for antioxidant defense. The exact mechanism by which this occurs is not fully understood, and immune hepatic damage, direct cytotoxic damage mediated by different viral products, and oxidative stress have been implicated in the pathogenesis of hepatitis C. . In recent years, the involvement of oxidative stress in the progression of hepatitis C has been demonstrated, and the immune response increases the production of reactive oxygen species. However, little is known about the involvement of oxidative stress in hepatitis C patients on combined treatment with PEG-IFN and RBV. Thus, the objective of this study was to determine oxidative stress profile in hepatitis C patients who used combination therapy with pegylated interferon alfa and ribavirin. A total of 43 patients with viral hepatitis C were recruited at the referral service in the city of Uruguaiana, and venous blood was collected. The HCV group was divided into four groups: diagnosis (free of combined pharmacological treatment), time 1 (onset of combined treatment), time 2 (half of the combined treatment), and time 3 (final of the combined treatment). The parameters of oxidative stress were determined by classical methodologies. The results show that HCV carriers had a significant increase in markers of hepatic function, and the activities of GOT (glutamic-oxaloacetic transaminase) and TGP (glutamic-pyruvic transaminase) are reestablished after the combined treatment. Enzymatic and non-enzymatic defenses were decreased in the HCV group relative to the control group, and combined antiviral therapy sometimes reversed these parameters. Oxidative damage to biomolecules was already increased in these carriers, and combined treatment improved these parameters, but in the control group, levels remained unchanged. Thus, the results suggest that HCV carriers have increased oxidative stress at the time of diagnosis, and combined treatment seems to improve this condition.