The relation of iron status and hemochromatosis gene mutations in patientswith chronic hepatitis C

Background & Aims: Elevated hepatic iron concentration may affect the respo nse to antiviral therapy in chronic hepatitis C. This study explored the co ntribution of genetic hemochromatosis to iron accumulation in chronic hepat itis C. Methods: HFE mutations (C282Y and H63D) were assessed in 184 patien ts with chronic hepatitis C virus and 487 controls. Liver biopsy specimens were available in 149 patients. Hepatic iron content was measured in 114 pa tients by atom-absorption spectrophotometry. Results: The C282Y and H63D al lele frequencies were 7.06 and 11.6 in patients and 4.83 and 11.09 in contr ols, respectively. Eight patients were homozygotes (5 C282Y [2.7%] and 3 H6 3D [1.6%]), 2 compound heterozygotes (1%), and 49 heterozygotes (14 C282Y [ 7.6%] and 35 H63D [19%]). Biochemical evidence of iron overload was more co mmon in patients with HFE mutations (28 of 47) than in those without (34 of 102; P = 0.0045). Histological iron grading and hepatic iron content overl apped among patients with or without mutations. A hepatic iron index of > 1 .9 was observed only in 1 of the 4 C282Y homozygotes and 1 of the 3 H63D ho mozygotes. Conclusions: HFE mutations contribute to but do not fully explai n hepatic iron accumulation in chronic hepatitis C. Furthermore, C282Y or H 63D homozygosity in chronic hepatitis C is not necessarily associated with a high hepatic iron content.