Comparison of Selenium Levels in HCV- Infected Patients at Different Stages of Disease
Comparison of Selenium Levels in HCV- Infected Patients at Different Stages of Disease
The incidence of hepatocellular carcinoma (HCC) is rising worldwide.One important etiology is
 a chronic inflammation due to hepatitis c (hcv) infection. Over the steps of a chronic
 inflammation over the stadium of cirrhosis of the liver it is possible that neoplastic
 nodules appear in the liver which can rise up to a HCC. In the pathogenesis of HCC oxidative
 stress seems to play an important role and as selenium is a key micronutrient in this process
 its levels could differ between the different stages of disease in hcv- infected patients.
 The aim of this trial is to examine these differences.
The incidence of hepatocellular carcinoma (HCC) is rising worldwide. Almost all cases of HCC
 develop over clearly defined stages of chronic hepatic inflammation and cirrhosis of the
 liver which can be determined as an irreversible stage during this process. In the Western
 world excessive alcohol consumption and chronic infection with the hepatitis c virus (hcv)
 are frequent causes of chronic hepatocellular injury. As HCC is often diagnosed at advanced
 stages and therapeutic intervention possibilities are limited it becomes more and more
 necessary to search for prevention strategies to stop the development of HCC.

 In the last years micronutrients such as selenium have reached the interests of oncologists.
 Several studies were able to show that there are often low selenium levels in patients with
 different tumors. Some epidemiologic studies showed that supplementation of selenium can
 decrease the incidence of some tumors.

 Oxidative stress is meant to play an essential role in hepatocarcinogenesis and as selenium
 could decrease it, it may be possible that patients infected with the hepatitis c - virus
 show low selenium levels probably as a result of the chronic hepatic inflammation. Moreover
 there may be differences between the stages of disease namely chronic infection, cirrhosis of
 the liver and hepatocellular carcinoma. The aim of this trial is to determine these
 differences.

 HCV- infected patients are enrolled in this trial. Three groups are formed: In Group 1 all
 HCV- infected patients with a chronic inflammation without cirrhosis of the liver and without
 HCC are summarized. in group 2 all HCV- infected patients with cirrhosis of the liver but
 without HCC are enrolled. In group 3 hcv- infected HCC- patients are summarized. In each
 group 10 patients should be enrolled, matched to age and other diseases. Blood samples are
 taken from these patients and selenium levels are measured.
Inclusion Criteria:

 -  patients with chronic hepatitis c- infection: no cirrhosis of the liver (= Desmet IV),
 no HCC - suspected lesion in the liver

 -  patients with hcv- associated cirrhosis of the liver: - cirrhosis of the liver
 confirmed by ultrasound, CT/MRI imaging or biopsy, all child - stages

 -  patients with hcv- associated HCC: diagnosis of HCC according to the AASLD criteria,
 HCC has not been treated at the time of enrollment, all BCLC- /UICC- stages.

 -  for all three groups: diagnosis of the chronic hcv- infection with virus rna and
 serologic parameters (anti-hcv) and abnormal liver function for more than 6 months, no
 antiviral treatment during the last 6 months

 Exclusion Criteria:

 -  application of dietary supplements

 -  excessive alcohol consumption

 -  all other etiologies leading to a liver injury

 -  patients with an acute-phase- reaction, SIRS or patients in intensive care units

 -  extrahepatic neoplasm

 -  rheumatic disease apart from hcv- associated immunologic phenomena

 -  diabetes mellitus I and II

 -  immunological diseases