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Clin Nutr. 2009 Feb;28(1):34-8. doi: 10.1016/j.clnu.2008.09.003. Epub 2008 Nov 29.

Vitamins B depletion, lower iron status and decreased antioxidative defense in patients with chronic hepatitis C treated by pegylated interferon alfa and ribavirin.

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  • 1Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan, ROC.



The impact of pegylated interferon combined with ribavirin upon the status of B vitamins, iron and oxidative stress in patients with hepatitis C virus (HCV) infection was examined.


Blood levels of B vitamins, iron status, and oxidative stress associated biomarkers were determined for 152 healthy controls and 109 HCV patients treated by pegylated interferon and ribavirin at three stages: before therapy, week 24 of treatment, and 48 weeks after therapy.


HCV infection significantly lowered vitamin B(6) and folate (p<0.05). Therapy caused further decrease in vitamin B(6) (p<0.05), and also significantly decreased vitamins B(1) and B(2) (p<0.05). This anti-HCV therapy caused more patients to exhibit insufficient iron status. HCV infection elevated plasma level of malondialdehyde and 8-isoprostane, and therapy further exacerbated lipid oxidation (p<0.05). HCV infection significantly lowered vitamin C and glutathione levels (p<0.05); therapy significantly reduced alpha-tocopherol and activity of glutathione peroxidase and superoxide dismutase (p<0.05).


This anti-HCV therapy elevated oxidative stress and depleted B vitamins and iron. Thus, the supplement of antioxidant agents, B vitamins and/or iron should be considered for patients with this therapy in order to avoid other healthy risk.

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