IRON STORES, RESPONSE TO ALPHA-INTERFERON THERAPY, AND EFFECTS OF IRON DEPLETION IN CHRONIC HEPATITIS-C

We studied 81 patients with chronic hepatitis C to investigate the rel ationship between iron and alpha-interferon response. Sixty-one patien ts (group A) were given alpha-interferon irrespective of iron status, whereas 20 (group B) with iron overload, were iron depleted before alp ha-interferon therapy. In group A, 21 patients responded to alpha-inte rferon and 40 were non-responders. Increased iron indices were signifi cantly more frequent in non-responders than responders. Multivariate a nalysis showed that among the independent variables evaluated, only ga mma-GT and liver iron concentration predicted therapy outcome. After p hlebotomy treatment, serum alanine aminotransferase fell significantly both in patients of group B (196+/-122 IU/l vs 82+/-37 IU/l, p<10(-6) ) and in 12 non-responders of group A (198+/-89 IU/l vs 107+/-81 IU/l, p<10(-6)). In 16 iron depleted patients, eight from each group, subse quent treatment with alpha-interferon produced a response in only one patient. These results suggest that increased liver iron is a negative prognostic factor for alpha-interferon response in chronic hepatitis C. Iron depletion had a beneficial effect on serum alanine aminotransf erase in all the patients treated, but did not improve the response to alpha-interferon. (C) Munksgaard, 1996.