Hepatic iron, liver steatosis and viral genotypes in patients with chronic hepat

April 20, 2006

Hepatic iron, liver steatosis and viral genotypes in patients with chronic

hepatitis C

Authors: Sebastiani, G.; Vario, A.; Ferrari, A.; Pistis, R.; Noventa, F.;

Alberti, A.

Source: Journal of Viral Hepatitis, Volume 13, Number 3, March 2006, pp.

199-205(7)

Publisher:Blackwell Publishing

Abstract:

Summary. & #8194;

Hepatic iron has been described in hepatitis C virus (HCV) infection as an

important cofactor of disease outcome. The mechanisms leading to hepatic

iron deposits (HIDs) in HCV patients are partially understood. We

investigated HIDs in the liver biopsies of a consecutive series of 242

HCV-infected patients with well-compensated liver disease. Serum ferritin

was elevated in 20.7% and transferrin saturation in 19.0%, while 38.8% had

stainable HIDs indicating that serum markers of systemic iron overload have

low sensitivity in predicting HIDs in hepatitis C. A cut-off value of serum

ferritin (350 & #8201;ìg/L in females and 450 & #8201;ìg/L in males) had good

negative predictive value in excluding presence of mild–moderate HIDs (grade

II–III). Hepatic iron deposits correlated by multivariate analysis with

serum ferritin [odds ratio (OR) 1.008, 95% confidence interval (CI)

1.005–1.011] and albumin (OR 1.15, 95% CI 1.02–1.297). Hepatic iron deposits

were more frequent in HCV-3-infected cases than in other genotypes

(P & #8201;= & #8201;0.027) while raised serum iron indices were more frequent

in non-HCV-3 genotypes (P & #8201;= & #8201;0.02). Furthermore, advanced

fibrosis (F3–F4 by METAVIR) was more frequent in non-HCV-3 genotypes

(P & #8201;= & #8201;0.04). In HCV-3 cases there was a close association between

HIDs and severe (grade II–III) steatosis (P & #8201;< & #8201;0.00001). These

results indicate that in well-compensated chronic hepatitis C HIDs are

strongly associated with HCV-3 and viral-induced hepatic steatosis, while in

the presence of other genotypes they might merely reflect a more advanced

stage of liver disease and/or a systemic iron overload. Serum ferritin could

identify a subgroup of patients in which the need of venesection could be

excluded without liver biopsy.

_________________________________________________________________

Is your PC infected? Get a FREE online computer virus scan from McAfee®

Recommended Posts