Iron stores, response to alpha-interferon therapy, and effects of iron depletion in chronic hepatitis C.
We studied 81 patients with chronic hepatitis C to investigate the relationship between iron and alpha-interferon response. Sixty-one patients (group A) were given alpha-interferon irrespective of iron status, whereas 20 (group B) with iron overload, were iron depleted before alpha-interferon therapy. In group A, 21 patients responded to alpha-interferon and 40 were non-responders. Increased iron indices were significantly more frequent in non-responders than responders. Multivariate analysis showed that among the independent variables evaluated, only gamma-GT and liver iron concentration predicted therapy outcome. After phlebotomy treatment, serum alanine aminotransferase fell significantly both in patients of group B (196 +/- 122 IU/l vs 82 +/- 37 IU/l, p < 10(-6)) and in 12 non-responders of group A (198 +/- 89 IU/l vs 107 +/- 81 IU/l, p < 10(-6)). In 16 iron depleted patients, eight from each group, subsequent treatment with alpha-interferon produced a response in only one patient. These results suggest that increased liver iron is a negative prognostic factor for alpha-interferon response in chronic hepatitis C. Iron depletion had a beneficial effect on serum alanine aminotransferase in all the patients treated, but did not improve the response to alpha-interferon.
Piperno
A
A
Istituto di Scienze Biomediche, Cattedra di Medicina Interna, Ospedale S. Gerardo dei Tintori, Monza e Università degli Studi di Milano, Italy.
Sampietro
M
M
D'Alba
R
R
Roffi
L
L
Fargion
S
S
Parma
S
S
Nicoli
C
C
Corbetta
N
N
Pozzi
M
M
Arosio
V
V
Boari
G
G
Fiorelli
G
G
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood / Q000378:metabolism; D005260:Female; D005293:Ferritins / Q000097:blood / Q000378:metabolism; D006526:Hepatitis C / Q000378:metabolism* / Q000628:therapy; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D007501:Iron / Q000378:metabolism*; D000090463:Iron Deficiencies; D019190:Iron Overload / Q000378:metabolism; D008099:Liver / Q000737:chemistry / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018962:Phlebotomy; D011379:Prognosis; D014168:Transferrin / Q000378:metabolism; D005723:gamma-Glutamyltransferase
D016898:Interferon-alpha; D014168:Transferrin; D005293:Ferritins; D007501:Iron; D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase