Liver iron is predictive of death in alcoholic cirrhosis: a multivariate study of 229 consecutive patients with alcoholic and/or hepatitis C virus cirrhosis: a prospective follow up study.
OBJECTIVE
A study was undertaken of liver biopsy samples from 229 consecutive patients with alcoholic or hepatitis C virus related cirrhosis who were prospectively followed until January 1996 to evaluate the influence of liver iron content on survival and the occurrence of hepatocellular carcinoma.


METHODS
Hepatic iron content was measured with a validated semiquantitative score, and its predictive value for survival and the occurrence of hepatocellular carcinoma was assessed.


RESULTS
130 patients had detectable iron at enrollment. During follow up (57 (28) months), 95 patients died and 39 patients developed hepatocellular carcinoma. No significant relation was found between hepatic iron and the occurrence of hepatocellular carcinoma. Conversely, the presence of iron was predictive of death in alcoholic patients (p = 0.007) by the log rank test but not in patients with hepatitis C virus related (p = 0.71) or mixed (p = 0.98) cirrhosis. The predictive value of hepatic iron content in patients with alcoholic cirrhosis was confirmed by the Cox model using either a binary coding (p = 0.009; relative risk = 2.27; 95% confidence interval 1.2 to 4.19) or the continuous values (p = 0.002).


CONCLUSIONS
These results suggest that hepatic iron enhances liver lesions caused by alcohol but not those caused by hepatitis C virus.
Ganne-Carrié
N
N
Service d'Hépato- Gastroentérologie, Hôpital Jean Verdier, 93143 Bondy Cedex, France.
Christidis
C
C
Chastang
C
C
Ziol
M
M
Chapel
F
F
Imbert-Bismut
F
F
Trinchet
J C
JC
Guettier
C
C
Beaugrand
M
M
D006528:Carcinoma, Hepatocellular / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000378:metabolism* / Q000401:mortality; D006801:Humans; D007501:Iron / Q000032:analysis*; D008099:Liver / Q000737:chemistry* / Q000821:virology; D008104:Liver Cirrhosis, Alcoholic / Q000378:metabolism* / Q000401:mortality; D008113:Liver Neoplasms / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015996:Survival Rate
D007501:Iron