Angiotensin converting enzyme (ACE D/I) polymorphism and its relation to liver fibrosis progression in Egyptian patients with chronic hepatitis C virus infection

Abstract

Hepatitis C virus (HCV) infection is a global health problem in Egypt and causes different liver disease spectrum. Evidence indicates that angiotensin I converting enzyme (ACE) gene polymorphism may play a role in determining disease progression. We aimed to determine the association of ACE gene I/D polymorphism with ACE serum levels and to examine the association between different I/D genotypes with the severity of hepatic fibrosis in chronic HCV infected Egyptian patients. Thirty controls and 90 HCV infected patients participated in the study, patients were subgrouped by Ishak stage of fibrosis into subgroup IIa (n=30; fibrosis score 0–1), subgroup IIb (n= 38; fibrosis score 2–3) and subgroup IIc (n= 22; fibrosis score 4–6).DNAwas multiplied by polymerase chain reaction (PCR). ACE genotype frequency in HCV infected patients was significantly different comparing to controls (X²= 7.169, P= 0.028). With non-significant difference in ACE D/I genotypes and allele frequencies among the patient subgroups (P >0.05),the frequency of the DD, DI and II genotypes in subgroup IIa, subgroup IIb and subgroup IIc were (53.3%, 36.6%, 10%), (44.7%, 44.7%, 10.5%) and (50%, 22.7%, 27%), respectively. The D and I allele frequency were (71.66%, 28.33%), (67.1%, 32.9%) and (61.36%, 38.63%), respectively. ACE serum levels were significantly increased in DD more than DI and II (t= 2.56, 3.43, P <0.05), respectively, with non-significant association in sonographic findings, viral load and liver function test (LFT) parameters with the ACE genotypes. Serum ACE levels were significantly increased in all patient subgroups when compared to controls with a non significant difference of ACE levels between subgroup IIb and IIc. We concluded that the D/D genotype is associated with HCV infection but not associated with degree or the progression of hepatic fibrosis.

Keywords: Angiotensin converting enzyme serum levels; Angiotensin converting enzyme gene polymorphism; Liver fibrosis progression; Hepatitis C viral infection