Abstract:Although erythrocyte filterability plays a key role in microcirculation, it is unknown whether the filterability of erythrocytes from patients with chronic hepatitis C (CH-C) is impaired. This study aimed to investigate erythrocyte filterability in CH-C patients in relation to medical treatment. The mean erythrocyte filterability (%) for all 24 patients with CH-C (69.2 ± 10.8%) was significantly lower than that for 5 normal controls (80.5 ± 1.7%, P < 0.03). In 8 patients, the combination therapy of ribavirin (RBV) and interferon improved liver function but caused anemia. The filterability after treatment (57.8 ± 12.8%) was lower than that before treatment (70.8 ± 9.7%, P < 0.05). Decreased filterability showed no correlation with the mean corpuscular volume or mean corpuscular Hb concentration during treatment, suggesting that the decrease in filterability mainly arises from changes in erythrocyte membrane properties. We investigated the protective effects of eicosapentaenoic acid (EPA) on the RBV-induced anemia. Filterability in 7 responders was markedly improved from 68.4 ± 4.6% to 77.4 ± 2.4% (P < 0.001), but not in 3 nonresponders. In the responders, the progression of anemia was restrained. In conclusion, we found an obvious impairment of the filterability of erythrocytes from CH-C patients, further impairment of the filterability induced by oxidative membrane damage caused by RBV leading to hemolytic anemia, and amelioration of the filterability caused by the antioxidative effects of EPA.Key words: chronic hepatitis, erythrocytes, filterability, eicosapentaenoic acid (EPA), oxidative stress.Hepatitis C virus (HCV) causes one of the most common and serious infections in Japan, affecting almost two million Japanese at present. Approximately 80% of patients with acute HCV infection will subsequently develop chronic infection, and an estimated 20% to 30% will develop cirrhosis and hepatocellular carcinoma [1]. The most effective treatment for chronic hepatitis C (CH-C) is antiviral combination therapy with interferon (IFN) and ribavirin (RBV) [2]. RBV is a water-soluble synthetic guanosine analog that exerts antiviral activity against DNA and RNA viruses after intracellular phosphorylation [3]. Current studies indicate that combination therapy with IFN and RBV (IFN/RBV) is associated with higher rates of sustained virological, biochemical, and histological responses compared to IFN monotherapy [4]. However, one of the major adverse effects of the combination therapy is RBV-induced hemolytic anemia; 67% of treated patients developed anemia [5]. This adverse effect has been ascribed to the accumulation of RBV triphosphate in erythrocytes, which leads to their oxidative injury [5,6]. It is therefore suspected that the hemolytic anemia stems from impaired erythrocyte deformability. However, there is little data available on the deformability of erythrocytes in patients with CH-C, as well as for the patients treated with IFN/RBV.The deformability of erythrocytes that pass through the microvascular network ...