Background: This study addressed the suggested association between levels of the antioxidants glutathione (GSH), vitamin C and vitamin E in peripheral blood and the histological activity and fibrosis stage in chronic hepatitis C (CHC). We then determined whether regular antioxidant supplementation influenced these antioxidant levels or disease severity.
Methods: Clinical, biochemical, histological and demographic data were collected from 247 CHC patients at the time of liver biopsy. Whole blood total GSH, plasma vitamin C and E were assessed by high-performance liquid chromatography. Statistical analyses were performed to test for associations between the variables and to identify independent predictors for hepatic necroinflammatory and fibrosis scores.
Results: GSH and vitamin C, but not vitamin E correlated with both portal/periportal activity (r=−0.19, P=0.004; r=−0.19, P=0.009 respectively) and fibrosis stage (r=−0.18, P=0.007; r=−0.18, P=0.009 respectively). GSH was an independent negative predictor of portal/periportal inflammation (P=0.02) and fibrosis (P=0.01). Vitamin C was an independent negative predictor of fibrosis stage (P=0.02). Antioxidant intake was associated with higher vitamin C (P<0.0001) and vitamin E (P=0.005) levels, but not GSH.
Conclusions: Whole blood GSH and plasma vitamin C are negatively associated with hepatic portal/periportal inflammation and fibrosis stage in CHC. Controlled intervention studies with vitamin C and agents that boost endogenous GSH levels are warranted.