Liver iron deposits in hepatitis B patients: association with severity of liver disease but not with hemochromatosis gene mutations.
OBJECTIVE
Iron deposits in the liver and abnormalities in serum iron biochemistry are frequently observed in patients with chronic liver diseases, but data for patients with hepatitis B virus (HBV) infection are scarce. Moreover, the role of HFE mutations in iron deposits in this condition remains unknown. The aim of the present study was to determine the prevalence of serum iron biochemical abnormalities and iron deposits in the liver of chronic HBV patients, and to evaluate the consequences for the activity and severity of liver disease. Additionally, we studied the role of HFE gene mutations in iron deposits.


METHODS
Eighty-one male non-cirrhotic HBV patients were studied. Serum iron biochemistry, liver enzymes and C282Y/H63D mutations were investigated. Liver biopsies were scored for necroinflammatory activity (histological activity index [HAI]), fibrosis and iron deposits.


RESULTS
Elevated transferrin saturation (TS) was found in 27.1% of patients and liver iron deposits in 48.7%; these deposits were mild in 68.4% and moderate in 31.6%. Patients with liver iron deposits exhibited significantly higher scores for HAI and fibrosis than those without iron deposits. HFE mutations were identified in 23.4% of patients (14 H63D heterozygotes, four H63D homozygotes, one compound mutation). No difference in the prevalence of C282Y and H63D mutations was observed between HBV patients (1.2% and 23.4%, respectively) and the general population (4.1% and 27.8%, respectively). No association was detected between HFE mutations and elevated TS or liver iron deposits.


CONCLUSIONS
Elevated TS and liver iron deposits were frequent in non-cirrhotic HBV patients. Iron deposits were mainly mild and associated with higher activity and severity of liver disease, but not with HFE mutations.
Department of Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. adlcmart@fmrp.usp.br
Ana L C
AL
Martinelli
Antonio B Araujo
AB
Filho
Rendrik F
RF
Franco
Marli H
MH
Tavella
Leandra N Z
LN
Ramalho
Sergio
S
Zucoloto
Sandra S
SS
Rodrigues
Marcos A
MA
Zago
D000293:Adolescent; D000328:Adult; D019694:Hepatitis B, Chronic / Q000235:genetics* / Q000473:pathology*; D006801:Humans; D007501:Iron / Q000032:analysis*; D008099:Liver / Q000737:chemistry* / Q000201:enzymology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D009154:Mutation; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
D007501:Iron