Associations between cellular immune effector function, iron metabolism, and disease activity in patients with chronic hepatitis C virus infection

We studied the associations of macrophage activity, T-helper cell types 1 a nd 2 (Th-1/Th-2) responses, and iron status in 55 patients with hepatitis C virus (HCV)-related liver disease and 28 control patients with noninfectio us liver disease. Serum concentrations of soluble tumor necrosis factor rec eptor type II (sTNFrec 75), a macrophage activation marker, were higher in cirrhotic than in noncirrhotic patients (P <.001) regardless of their HCV s tatus, whereas levels of neopterin, interleukin (IL)-4 and IL-10 did not di ffer significantly, In HCV-positive patients, sTNFrec 75 levels and transfe rrin saturation (TfS) correlated positively with levels of aspartate transa minase (P <.001 for sTNFrec 75 and P =.028 for TfS) and alanine transaminas e (P =.003 for sTNFrec 75 and P =.039 for TfS), Increased TfS correlated si gnificantly with both advanced liver disease and a predominant Th-2 pattern in HCV patients. Our data suggest that an association exists between macro phage activation and hepatic dysfunction, and that iron status may affect t he clinical course of HCV infection by modulating Th-1/Th-2 responses in vi vo.