ELEVATED SERUM IRON PREDICTS POOR RESPONSE TO INTERFERON TREATMENT INPATIENTS WITH CHRONIC HCV INFECTION

To date, there are no firm clinical, demographic, biochemical, serolog ic, or histologic features predicting which patients with chronic hepa titis C are more likely to respond to therapy with interferon-alpha. S erum iron, total iron-binding capacity, transferrin saturation, and fe rritin were measured in the fasting state. The amount of stainable iro n in liver biopsy specimens was evaluated histochemically as well. All patients received subcutaneous recombinant human IFN-alpha 2a three m illion units thrice weekly by self-administration. Eleven of 13 (84%) responders had low to normal serum iron levels as compared to one of 2 6 (4%) nonresponders (P < 0.001). The serum transferrin was similar in both groups, but iron saturation was significantly lower in responder s (30 +/- 10%) than in nonresponders (53 +/- 12%) (P < 0.001). Serum f erritin and hepatic iron content were higher in nonresponders (NS). It is suggested that increased serum iron and transferrin saturation blu nt the action of interferon, as they have opposite effects on the immu ne system. Iron overload can thus lead to a poor response to interfero n. It remains to be seen whether reducing iron overload will improve t he response to interferon therapy.