TY - JOUR
T1 - Liver iron influences the response to interferon alpha therapy in chronic hepatitis C
AU - Fargion, Silvia
AU - Ludovica Fracanzani, Anna
AU - Sampietro, Maurizio
AU - Molteni, Virginio
AU - Boldorini, Renzo
AU - Mattioli, Michela
AU - Cesana, Bruno
AU - Lunghi, Giovanna
AU - Piperno, Alberto
AU - Valsecchi, Carla
AU - Fiorelli, Gemino
PY - 1997
Y1 - 1997
N2 - Objective: To define whether there is any relation between the iron status of patients with hepatitis C virus (HCV) chronic liver disease anti their response to interferon therapy. Design: To evaluate the long-term response to 1 year of interferon therapy with addition of phlebotomies after 3 months of treatment if at that time alanine aminotransferase (ALT) had not normalized in a group of patients with HCV-positive chronic liver disease whose iron status had been characterized. Setting: A northern Italian hospital. Participants: Fifty-eight anti-HCV-positive patients (four HCV-RNA negative) with biopsy proven chronic hepatitis and no evidence of iron overload as indicated by normal transferrin saturation at the time of enrolment in the study. Intervention: Three times a week intramuscular injection of alpha interferon 3 MU for 1 year with addition of phlebotomies (350 ml/week) till iron depletion if after 3 months of interferon therapy ALT had not normalized. Results: A long-term response was observed in 19 of the 52 patients who completed the treatment, four HCV-RNA negative and 15 positive. The four RNA-negative and seven of the 15 RNA-positive long-term responders had been treated with interferon alone, and the other eight also with phlebotomies. At univariate analysis only HCV genotype, gamma-glutamyltranspeptidase and liver iron concentration were significantly associated with response whereas sinusoidal iron deposition was of borderline significance. No association was found with sex, age, duration of disease, histology, Knodell score, transferrin saturation %, serum ferritin, hepatocytic iron score, and portal iron score. HCV-RNA serum levels, measured in 29 patients, did not correlate with response. At multivariate analysis liver iron concentration was still significant and one unit reduction of liver iron concentration (natural logarithm transformed) was associated with 2.95 odds ratio of response. Conclusion: These results indicate that iron in the liver is more closely related to response to interferon than the other variables considered, including HCV characteristics.
AB - Objective: To define whether there is any relation between the iron status of patients with hepatitis C virus (HCV) chronic liver disease anti their response to interferon therapy. Design: To evaluate the long-term response to 1 year of interferon therapy with addition of phlebotomies after 3 months of treatment if at that time alanine aminotransferase (ALT) had not normalized in a group of patients with HCV-positive chronic liver disease whose iron status had been characterized. Setting: A northern Italian hospital. Participants: Fifty-eight anti-HCV-positive patients (four HCV-RNA negative) with biopsy proven chronic hepatitis and no evidence of iron overload as indicated by normal transferrin saturation at the time of enrolment in the study. Intervention: Three times a week intramuscular injection of alpha interferon 3 MU for 1 year with addition of phlebotomies (350 ml/week) till iron depletion if after 3 months of interferon therapy ALT had not normalized. Results: A long-term response was observed in 19 of the 52 patients who completed the treatment, four HCV-RNA negative and 15 positive. The four RNA-negative and seven of the 15 RNA-positive long-term responders had been treated with interferon alone, and the other eight also with phlebotomies. At univariate analysis only HCV genotype, gamma-glutamyltranspeptidase and liver iron concentration were significantly associated with response whereas sinusoidal iron deposition was of borderline significance. No association was found with sex, age, duration of disease, histology, Knodell score, transferrin saturation %, serum ferritin, hepatocytic iron score, and portal iron score. HCV-RNA serum levels, measured in 29 patients, did not correlate with response. At multivariate analysis liver iron concentration was still significant and one unit reduction of liver iron concentration (natural logarithm transformed) was associated with 2.95 odds ratio of response. Conclusion: These results indicate that iron in the liver is more closely related to response to interferon than the other variables considered, including HCV characteristics.
KW - Cellular iron distribution
KW - Chronic hepatitis C
KW - Interferon
KW - Liver iron concentration
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M3 - Article
C2 - 9187884
AN - SCOPUS:8244248790
VL - 9
SP - 497
EP - 503
JO - European Journal of Gastroenterology and Hepatology
JF - European Journal of Gastroenterology and Hepatology
SN - 0954-691X
IS - 5
ER -