title: Hepatic iron accumulation is associated with disease progression and resistance to interferon/ribavirin combination therapy in chronic hepatitis C.
abstract: OBJECTIVE
  Liver iron accumulation in patients with chronic hepatitis C (CHC) has received increasing attention in recent years. The aim of this study was to determine the prevalence and severity of liver iron deposition in CHC, to assess its relationship with clinical, biochemical and histological characteristics, and to study its influence on the response to interferon (IFN) plus ribavirin combination therapy.
  
  
  METHODS
  We studied liver biopsy specimens from 103 hepatitis C virus (HCV) and 34 hepatitis B virus (HBV) infected patients and total iron score (TIS) was measured. Seventy patients infected with HCV genotype 1b were treated with IFN/ribavirin for 24 weeks.
  
  
  RESULTS
  CHC patients had a significantly higher TIS than chronic hepatitis B (CHB) patients (7.03 +/- 5.34 vs 4.41 +/- 4.49, P = 0.0056). TIS was significantly correlated with alcohol intake (P = 0.0213, r = 0.290), transaminase level (P = 0.0126, r = 0.247), platelet count (P = 0.0002, r = -0.369), histological grading (P = 0.0121, r = 0.248) and staging (P = 0.0003, r = 0.356) in CHC patients. Pretreatment TIS was significantly higher in non-sustained virological responders (SVR) than in SVR to IFN/ribavirin treatment (TIS = 7.69 +/- 5.76 vs 4.39 +/- 3.27, P = 0.0310). Multiple regression analysis showed that TIS was the only independent variable associated with resistance to IFN/ribavirin (P = 0.0277).
  
  
  CONCLUSIONS
  Liver iron deposition was common in CHC compared to CHB and was associated with liver disease progression. Increased hepatic iron stores in CHC were related to resistance to IFN/ribavirin treatment.
authors.affiliation: Department of Gastroenterology and Hepatology, Division of Clinical Medicine and Biomedical Science, Institute of Medical Science, Mie University Graduate School of Medicine, Mie, Japan. nfujita@clin.medic.mie-u.ac.jp
authors.forename: Naoki
authors.initials: N
authors.lastname: Fujita
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Sugimoto
authors.forename: Naohito
authors.initials: N
authors.lastname: Urawa
authors.forename: Jun
authors.initials: J
authors.lastname: Araki
authors.forename: Rumi
authors.initials: R
authors.lastname: Mifuji
authors.forename: Mika
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Horiike
authors.forename: Hideaki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Motoh
authors.initials: M
authors.lastname: Iwasa
authors.forename: Yoshinao
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Adachi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kaito
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D000998:Antiviral Agents / Q000627:therapeutic use*; D018450:Disease Progression; D024921:Drug Resistance, Multiple, Viral; D004359:Drug Therapy, Combination; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D007501:Iron / Q000378:metabolism*; D019190:Iron Overload / Q000378:metabolism / Q000473:pathology / Q000821:virology*; D008099:Liver / Q000378:metabolism* / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use*; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D000637:Transaminases / Q000097:blood; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D012254:Ribavirin; D007501:Iron; D000637:Transaminases