Liver iron is a surrogate marker of severe fibrosis in chronic hepatitis C.
OBJECTIVE
Patients with chronic hepatitis C have frequently mild to moderate liver iron overload which increases with fibrosis stage. Thus, it has been postulated that iron could enhance the progression of fibrosis. However, the real impact of iron is still controversial. The study was undertaken to determine the effect of confounding variables. All factors known to influence both iron overload and fibrosis were taken into account.


METHODS
Five hundred and eighty-six patients, who had liver biopsy performed prior to antiviral treatment, were included. Serum ferritin and liver iron were correlated with clinical, biological and histological variables in univariate and multivariate analysis. The impact of iron on fibrosis was evaluated in multivariate analysis in the whole group and in the subgroup of 380 patients with available date of infection.


RESULTS
Hyperferritinemia, encountered in 27%, was associated with liver iron deposits in only 46% of cases. Liver iron was elevated in 17%, and correlated with age, male sex, and alcohol intake. The univariate strong link which existed between liver iron and fibrosis disappeared after adjustment for confounding variables.


CONCLUSIONS
According to the results of this study, liver iron should be considered more as a surrogate marker for disease severity than as a fibrogenic factor per se.
Guyader
Dominique
D
Liver unit and INSERM U522, University of Rennes, France. Dominique.Guyader@univ-rennes1.fr
Thirouard
Anne-Sophie
AS
Erdtmann
Lars
L
Rakba
Nafissa
N
Jacquelinet
Sylvie
S
Danielou
Hélène
H
Perrin
Michèle
M
Jouanolle
Anne-Marie
AM
Brissot
Pierre
P
Deugnier
Yves
Y
D000328:Adult; D000375:Aging; D000428:Alcohol Drinking; D015415:Biomarkers / Q000378:metabolism; D005260:Female; D005293:Ferritins / Q000097:blood; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000378:metabolism*; D006801:Humans; D007501:Iron / Q000097:blood / Q000378:metabolism*; D008099:Liver / Q000378:metabolism*; D008103:Liver Cirrhosis / Q000209:etiology* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012737:Sex Factors
D015415:Biomarkers; D005293:Ferritins; D007501:Iron