[Markers of endothelial dysfunction (VCAM-1 and vWF) in chronic hepatitis C]

AIM. To estimate the blood levels of endothelial factors (soluble vascular adhesion molecule 1 (sVCAM-1) and von Willebrand factor (vWF:Ag)) in relation to the magnitude of the biochemical, histological, and virological characteristics of chronic hepatitis C (CHC).

The investigation enrolled 69 patients with asymptomatic CHC. The mean age of the examined was 33.6 +/- 7.8 years. Laboratory examination included a standard set of clinical and biochemical parameters for chronic hepatitides. The stage of hepatic fibrosis (HF) and the degree of histological activity were determined by the METAVIR scale based on histological examination of liver biopsy specimens, by using the calculated FibroTest (BioPredictive, France) and indirect ultrasonic liver elastometric assay (Fibroscan). The serum content of sVCAM-1 and vWF:Ag were measured by ELISA.

Elevated sVCAM-1 and/or vWF:Ag levels were found in 33.3% of the patients with CHC. There was a significantly higher increase in blood sVCAM-1 levels in patients with cytolytic syndrome than in those with normal alanine aminotransferase activity. Particularly high sVCAM-1 levels (more than twice higher) were recorded in the CHC patients with severe HF (F3-F4) than in those with milder HF (F0-F2) (1966.98 (1299.79, 3451.73) and 975.98 (888.94, 1226.13) ng/ml (p < 0.001). There were higher blood levels of vWF:Ag in the patients with severe HF (F3-F4) than in those with early-stage HF (FO-F2)--1.61 (1.29; 1.81) and 1.31 (1.15, 1.45) U/ml; p < 0.05).

In the patients with HCH, the found elevated blood sVCAM-1 and vWF:Ag levels related to the biochemical activity of hepatitis and, to a greater extent, with the degree of HF can judge the implication of endothelial dysfunction in the pathogenesis of chronic HCV infection.