Complete blood count, measures of iron status and inflammatory markers in inner-city African Americans with undiagnosed hepatitis C seropositivity

Abstract

Background: Hepatitis C virus (HCV) infection may be associated with thrombocytopenia and increased iron stores in patients receiving medical care. We aimed to determine how often changes in hematologic, iron metabolic and inflammatory markers occur in individuals with undiagnosed HCV in the community.

Methods: Inner-city African Americans (n=143) were recruited from the community according to reported ingestion of alcohol. They were divided broadly into those who drank more or less than 56 g alcohol/day as assessed by dietary questionnaire. HCV serology was determined and laboratory values were compared according to HCV seropositivity in analyses that adjusted for alcohol consumption.

Results: The prevalence of HCV seropositivity was 23% among men and 29% among women. Levels of hepatocellular enzymes were higher with HCV seropositivity (P<0.0001) but hemoglobin concentrations, white blood cell and platelet counts and serum ferritin concentrations did not differ. The globulin fraction of the serum protein concentration (P=0.002) was increased with HCV seropositivity as expected with chronic inflammation. However, erythrocyte sedimentation rate and serum iron and haptoglobin levels did not differ significantly according to HCV status. Furthermore, multivariate analysis revealed that C-reactive protein was decreased and transferrin concentration was increased with both HCV and alcohol consumption (P<0.014).

Conclusions: Previously undiagnosed HCV seropositivity has little effect on the complete blood count and body iron stores but appears to perturb the response to an inflammatory stimulus, causing reduced rather than increased circulating CRP concentrations and increased rather than decreased transferrin concentrations.

Figure 1

Relationships among C-reactive protein, HCV seropositivity, erythrocyte sedimentation rate and alcohol intake. a. Correlation between C-reactive protein concentration and erythrocyte sedimentation rate in HCV seronegative and seropositive cases. b. Correlation between C-reactive protein and alcohol intake in HCV seronegative and seropositive cases.

Figure 2

Relationships among serum transferrin concentration, HCV seropositivity, serum ferritin concentration and alcohol intake. a. Correlation between serum concentrations of transferrin and ferritin in HCV seronegative and seropositive cases. b. Correlation between serum transferrin concentration and estimated alcohol intake in HCV seronegative and seropositive cases.