THE INFLUENCE OF IRON ON CHRONIC HEPATITIS-C

It has recently been suggested that the hepatic iron concentration can be used to predict the response to interferon in patients with chroni c hepatitis C. An hepatic iron concentration greater than 1100 mu g/g appears to identify a group of patients that are unlikely to respond t o alpha-interferon, It is not known whether this relationship can be e xplained by associated variables such as age, gender or disease severi ty or whether the hepatic iron concentration itself influences the res ponse to interferon. Furthermore, the hepatic iron concentration is of no value in discriminating responders from nonresponders in patients with hepatic iron concentrations less than 1100 mu g/g. The possibilit y of improving response rates to interferon by pretreatment venesectio n needs to be explored but currently only limited data are available. Venesection results in a significant fall in the serum transaminases b ut the preliminary results regarding the efficacy of subsequent interf eron therapy are unclear. Until the results of prospective controlled trials are available it is concluded that the available evidence does not support venesection before interferon therapy for chronic hepatiti s C.