Serum aminotransferase levels as an indicator of the effectiveness of venesection for chronic hepatitis C.
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.
Hayashi
H
H
Research Laboratory for Development of Medicine, Faculty of Pharmaceutical Sciences, Hokuriku University, Kanazawa, Japan.
Takikawa
T
T
Nishimura
N
N
Yano
M
M
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*
D006454:Hemoglobins; D005293:Ferritins; D007501:Iron; D000637:Transaminases; D000410:Alanine Transaminase