Hemochromatosis in Italy in the last 30 years: Role of genetic and acquired factors

Anna Ludovica Fracanzani, Alberto Piperno, Luca Valenti, Mirella Fraquelli, Sabina Coletti, Alessandra Maraschi, Dario Consonni, Enzo Coviello, Dario Conte, Silvia Fargion

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30 Citations (Scopus)

Abstract

The clinical presentation of hereditary hemochromatosis has changed markedly in recent years. The aim of this study was to analyze a large series of consecutive Italian patients with hemochromatosis diagnosed between 1976 and 2007 to determine whether the genetic background and the presence of acquired risk factors influenced the severity of iron overload and the natural history of the disease. A cohort of 452 Italian patients with iron overload-338 HFE-related (C282Y homozygotes or compound C82Y/H63D heterozygotes) and 114 non-HFE-related-were followed prospectively for a median of 112 months. Alcohol intake, smoking habits, and iron removed to depletion were similar in patients with and without HFE-related iron overload. Hepatitis B virus (4% and 9%; P = 0.04) and hepatitis C virus (6% and 19%; P = 0.002) infections were more frequent in patients with non-HFErelated iron overload. Seventy-three percent of patients with HFE and 61% of patients with non-HFE-related disease had no acquired risk factor. Cirrhosis was significantly more frequent in non-HFE patients independent of the presence of acquired risk factors (P = 0.02). Sex, alcohol intake, prevalence of smoking, hepatitis C virus infection, glucose, lipids, iron-related parameters, and prevalence of C282Y/H63D differed significantly over the years. At enrollment, cirrhosis was present in 145 cases and was significantly more frequent in the first decade (80%, 47%, and 13%; P = 0.001). Survival did not differ across the decades in cirrhotic patients; hepatocellular carcinoma occurred similarly in HFE and non-HFE patients. Conclusion: Patients with HFE and non-HFE-related iron overload have comparable iron overload and similar clinical history. Patients who were diagnosed during the last 10 years and were not identified as cirrhotic at enrollment have less severe disease and lower prevalence of acquired risk factors, independent of genetic background.

Original languageEnglish
Pages (from-to)501-510
Number of pages10
JournalHepatology
Volume51
Issue number2
DOIs
Publication statusPublished - Feb 2010

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Hemochromatosis
Italy
Iron Overload
Hepacivirus
Fibrosis
Iron
Smoking
Alcohols
Homozygote
Virus Diseases
Heterozygote
Hepatitis B virus
Habits
Hepatocellular Carcinoma
Lipids

ASJC Scopus subject areas

  • Hepatology

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Hemochromatosis in Italy in the last 30 years : Role of genetic and acquired factors. / Fracanzani, Anna Ludovica; Piperno, Alberto; Valenti, Luca; Fraquelli, Mirella; Coletti, Sabina; Maraschi, Alessandra; Consonni, Dario; Coviello, Enzo; Conte, Dario; Fargion, Silvia.

In: Hepatology, Vol. 51, No. 2, 02.2010, p. 501-510.

Research output: Contribution to journalArticle

Fracanzani, Anna Ludovica ; Piperno, Alberto ; Valenti, Luca ; Fraquelli, Mirella ; Coletti, Sabina ; Maraschi, Alessandra ; Consonni, Dario ; Coviello, Enzo ; Conte, Dario ; Fargion, Silvia. / Hemochromatosis in Italy in the last 30 years : Role of genetic and acquired factors. In: Hepatology. 2010 ; Vol. 51, No. 2. pp. 501-510.
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abstract = "The clinical presentation of hereditary hemochromatosis has changed markedly in recent years. The aim of this study was to analyze a large series of consecutive Italian patients with hemochromatosis diagnosed between 1976 and 2007 to determine whether the genetic background and the presence of acquired risk factors influenced the severity of iron overload and the natural history of the disease. A cohort of 452 Italian patients with iron overload-338 HFE-related (C282Y homozygotes or compound C82Y/H63D heterozygotes) and 114 non-HFE-related-were followed prospectively for a median of 112 months. Alcohol intake, smoking habits, and iron removed to depletion were similar in patients with and without HFE-related iron overload. Hepatitis B virus (4{\%} and 9{\%}; P = 0.04) and hepatitis C virus (6{\%} and 19{\%}; P = 0.002) infections were more frequent in patients with non-HFErelated iron overload. Seventy-three percent of patients with HFE and 61{\%} of patients with non-HFE-related disease had no acquired risk factor. Cirrhosis was significantly more frequent in non-HFE patients independent of the presence of acquired risk factors (P = 0.02). Sex, alcohol intake, prevalence of smoking, hepatitis C virus infection, glucose, lipids, iron-related parameters, and prevalence of C282Y/H63D differed significantly over the years. At enrollment, cirrhosis was present in 145 cases and was significantly more frequent in the first decade (80{\%}, 47{\%}, and 13{\%}; P = 0.001). Survival did not differ across the decades in cirrhotic patients; hepatocellular carcinoma occurred similarly in HFE and non-HFE patients. Conclusion: Patients with HFE and non-HFE-related iron overload have comparable iron overload and similar clinical history. Patients who were diagnosed during the last 10 years and were not identified as cirrhotic at enrollment have less severe disease and lower prevalence of acquired risk factors, independent of genetic background.",
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AU - Coletti, Sabina

AU - Maraschi, Alessandra

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AB - The clinical presentation of hereditary hemochromatosis has changed markedly in recent years. The aim of this study was to analyze a large series of consecutive Italian patients with hemochromatosis diagnosed between 1976 and 2007 to determine whether the genetic background and the presence of acquired risk factors influenced the severity of iron overload and the natural history of the disease. A cohort of 452 Italian patients with iron overload-338 HFE-related (C282Y homozygotes or compound C82Y/H63D heterozygotes) and 114 non-HFE-related-were followed prospectively for a median of 112 months. Alcohol intake, smoking habits, and iron removed to depletion were similar in patients with and without HFE-related iron overload. Hepatitis B virus (4% and 9%; P = 0.04) and hepatitis C virus (6% and 19%; P = 0.002) infections were more frequent in patients with non-HFErelated iron overload. Seventy-three percent of patients with HFE and 61% of patients with non-HFE-related disease had no acquired risk factor. Cirrhosis was significantly more frequent in non-HFE patients independent of the presence of acquired risk factors (P = 0.02). Sex, alcohol intake, prevalence of smoking, hepatitis C virus infection, glucose, lipids, iron-related parameters, and prevalence of C282Y/H63D differed significantly over the years. At enrollment, cirrhosis was present in 145 cases and was significantly more frequent in the first decade (80%, 47%, and 13%; P = 0.001). Survival did not differ across the decades in cirrhotic patients; hepatocellular carcinoma occurred similarly in HFE and non-HFE patients. Conclusion: Patients with HFE and non-HFE-related iron overload have comparable iron overload and similar clinical history. Patients who were diagnosed during the last 10 years and were not identified as cirrhotic at enrollment have less severe disease and lower prevalence of acquired risk factors, independent of genetic background.

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