IRON AND CHRONIC VIRAL-HEPATITIS - EMERGING EVIDENCE FOR AN IMPORTANTINTERACTION

Iron is an essential element for cell survival; it serves as a cofacto r for essential enzymes in oxidative metabolism and (in the form of he me) as the major oxygen transporter in most forms of life on earth. Bo th deficiency and excess of iron often lead to disease. Iron is necess ary for the proliferation of microorganisms and neoplastic cells. The presence of iron overload facilitates infection, as evidenced by the i ncreased risk of persons with hemochromatosis to certain infections an d by the fact that patients with lesser amounts of hepatic iron appear to respond better to interferon therapy for chronic viral hepatitis t hat those with larger amounts of hepatitic iron. Viral hepatitis is a common cause of morbidity and mortality. Recent studies suggest that t here is a key link between iron metabolism and the pathophysiology of viral hepatitis. The lobular and cellular distribution of iron in the liver may be as important as the total quantity of iron present. Wheth er iron removal will prove useful in the long-term management of chron ic viral hepatitis is an issue in need of further well-designed, rando mized, controlled trials.