Accelerated hepatic fibrosis in patients with combined hereditary hemochromatosis and chronic hepatitis C infection.
OBJECTIVE
Hereditary hemochromatosis (HH) and chronic hepatitis C virus (HCV) infection can both result in hepatic fibrosis and cirrhosis. It has been proposed that iron overload and HCV may have potentiating effects on hepatic fibrogenesis. This study determined if HH patients with HCV would present with hepatic fibrosis/cirrhosis at a younger age and at a lower hepatic iron concentration compared to patients with HH or HCV alone.


METHODS
Ten patients with combined HCV and HH were compared to 13 patients who had HH alone and 24 patients who had HCV alone. All patients had advanced fibrosis/cirrhosis on liver biopsy. All HH patients were homozygous for the C282Y mutation.


RESULTS
At presentation with advanced fibrosis/cirrhosis, the mean age of the HH/HCV group was significantly lower than that of the HH group and the HCV group. The mean hepatic iron concentration was lower in the combined HH/HCV group compared to that of the HH group.


CONCLUSIONS
HH patients with HCV present with advanced fibrosis/cirrhosis at a younger age and at a lower hepatic iron concentration compared to HH patients without HCV. These findings support the concept that the combination of HH-induced iron overload and HCV has a potentiating effect on hepatic fibrogenesis.
Diwakaran
Hari H
HH
Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, 3635 Vista Avenue, St. Louis, MO 63110-0250, USA
Befeler
Alex S
AS
Britton
Robert S
RS
Brunt
Elizabeth M
EM
Bacon
Bruce R
BR
D000328:Adult; D017668:Age of Onset; D000410:Alanine Transaminase / Q000097:blood; D005293:Ferritins / Q000097:blood; D006432:Hemochromatosis / Q000097:blood / Q000150:complications* / Q000821:virology; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000821:virology; D008297:Male; D008875:Middle Aged; D014168:Transferrin / Q000378:metabolism
D014168:Transferrin; D005293:Ferritins; D000410:Alanine Transaminase