title: Serum aminotransferase levels as an indicator of the effectiveness of venesection for chronic hepatitis C.
abstract: OBJECTIVE
  Iron cytotoxicity may play an important role in chronic hepatitis C. The effects of venesection suggest that a slight iron overload contributes to hepatic injury in subjects infected with hepatitis C virus. A better indication of the efficacy of venesection was studied in patients with and without overt iron overloading.
  
  
  METHODS
  All 40 patients had chronic hepatitis C but none had hemochromatosis of a known etiology. A serum ferritin level of 10 ng/ml or less was chosen as the treatment goal. A mean blood volume of 2400 +/- 1100 ml was removed during treatments lasting 5 +/- 3 months.
  
  
  RESULTS
  Treatment significantly reduced the mean serum levels of alanine aminotransferase activity from 128 +/- 74 to 63 +/- 28 IU/l (p < 0.01). The baseline enzyme activity was highly correlated with reduction in activity after treatment (r = 0.94, p < 0.01), but the baseline levels of ferritin and histochemistry for iron showed poor correlations with the reduction in enzyme activity (r = 0.63 with p < 0.01 and r = 0.38 with p < 0.05, respectively).
  
  
  CONCLUSIONS
  Thus, serum levels of aminotransferases were a more important indicator for venesection than conventional indices of iron overload, probably because cytotoxic iron includes some reactive iron species rather than stored iron alone.
authors.affiliation: Research Laboratory for Development of Medicine, Faculty of Pharmaceutical Sciences, Hokuriku University, Kanazawa, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Hayashi
authors.forename: T
authors.initials: T
authors.lastname: Takikawa
authors.forename: N
authors.initials: N
authors.lastname: Nishimura
authors.forename: M
authors.initials: M
authors.lastname: Yano
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001815:Bloodletting; D002908:Chronic Disease; D005260:Female; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000378:metabolism; D006526:Hepatitis C / Q000201:enzymology* / Q000628:therapy*; D006801:Humans; D007501:Iron / Q000097:blood; D008297:Male; D008875:Middle Aged; D000637:Transaminases / Q000097:blood*
chemical_list: D006454:Hemoglobins; D005293:Ferritins; D007501:Iron; D000637:Transaminases; D000410:Alanine Transaminase