IRON OVERLOAD IN PATIENTS WITH CHRONIC VIRAL-HEPATITIS - HOW COMMON IS IT

Objectives: To establish the prevalence of increased hepatic iron cont ent in patients with hepatitis C virus-related chronic hepatitis and t o assess the accuracy of serum iron and ferritin in detecting tissue i ron overload. Methods: Serum iron, serum ferritin, and hepatic iron co ntent were determined in 81 consecutive patients undergoing liver biop sy for chronic ALT elevation and hepatitis C virus infection. Moreover , in a subgroup of 28 patients, outcome of a 6-month course of interfe ron (IFN) treatment (6 million U of recombinant IFN, three times weekl y) was determined after a mean follow-up of 24 +/- 6 months and the ou tcome was compared with the pretreatment values of hepatic iron conten t. Results: Elevated serum iron or ferritin levels were detected in ap proximately 40 % of patients, but elevated hepatic iron content was ob served in only eight patients (10%). One of these patients had a hepat ic iron index > 1.9, indicating hemochromatosis. Liver iron content an d serum iron levels were not correlated. No differences in hepatic iro n content were observed among patients with a sustained response to IF N (seven patients), short-term responders (seven patients), or nonresp onders (14 patients). Conclusions: Ten percent of patients with chroni c hepatitis C have elevated hepatic iron content. These patients canno t be identified using serum markers of iron status. The relationship b etween liver iron and response to IFN treatment requires further prosp ective investigations.