Liver iron accumulation in patients with chronic active hepatitis C: prevalence and role of hemochromatosis gene mutations and relationship with hepatic histological lesions

Background/Aims: Liver iron accumulation has been described in patients wit h chronic active hepatitis (CAH-I) C, and could play a role in the course o f liver disease and negatively influence the response to interferon, The ai m of this study was to determine the prevalence and severity of liver iron accumulation in CAH C, to-assess its relationship with the HFE C282Y and H6 3D mutations, and to study its interactions with hepatic histological lesio ns. Methods: Two hundred and nine patients (131 men, 78 women, mean age 44.3+/- 12.0 years) with CAH C, including 19 patients with cirrhosis (9.1%) were st udied, a semiquantitative grading system from 0 to 3 was used for histologi cal assessment of liver iron accumulation on Perls' staining, The HFE C282Y and H63D mutations were screened for by restriction enzyme analysis perfor med on PCR-amplified products, Histological scores of activity and fibrosis were determined according to a previously validated METAVIR score system. Results: Liver iron accumulation was found in 88/209 patients (42.1%), and was generally mild, The C282Y and H63D allele frequencies were in 23 (11.0% ), and 50 (23.9%), respectively, No association was found between the prese nce of liver iron accumulation and the detection of the C282Y and H63D muta tions, A significant relationship was found between the severity of histolo gical activity and liver iron accumulation of macrophagic or mixed (i.e. bo th macrophagic and hepatocytic) type (p=0.04), Although the number of cirrh otic patients was small, cirrhosis was more frequently observed in patients with than without liver iron accumulation (17.2% vs. 3.3%, p=0.004). Conclusions: Overall, these data suggest that the liver iron accumulation i n patients with CAH C is significantly associated with histological activit y and cirrhosis, whereas the two missense hemochromatosis gene mutations ar e not major determinants.