EVALUATION OF IRON STATUS IN PATIENTS WITH CHRONIC HEPATITIS-C

Aim. To evaluate the prevalence of iron overload in chronic hepatitis C and its relationship with Liver histology Patients and Methods. Seru m iron, unsaturated iron binding capacity and ferritin levels were det ermined in 204 consecutive anti-hepatitis C virus positive subjects, w hereas hepatic iron concentration, hepatic histological grading and st aging, hepatitis C virus genotypes were further assessed in a subgroup of 50 patients who underwent liver biopsy for chronic hepatitis. Resu lts, An increase in the serum markers of iron metabolism was more freq uently found in subjects with aminotransferase activities above the no rmal range, whereas hepatic iron overload, established by direct hepat ic iron determination, was found only in 9/50 (18%) patients with chro nic hepatitis C. No sei-um iron marker could reliably predict hepatic iron stores. Patients with mild iron overload usually showed active he patitis and fibrosis, whereas iron overload was not present in patient s without fibrosis or with very mild fibrosis. Two out of nine patient s with iron overload were shown to be beta thalassaemia heterozygous, and two were heterozygous carriers of a putative haemochromatosis gene mutation (His63Asp). Conclusions. Many anti-hepatitis C virus positiv e patients with elevated aminotransferase activities have serum ferrit in levels above the normal range, but only a minority of patients with chronic hepatitis C have a mild iron overload. in chronic hepatitis C , a relationship does exist between hepatic iron content and liver fib rosis.