title: Oscillations in serum ferritin associated with antiviral therapy in chronic hepatitis C.
abstract: BACKGROUND
  Hyperferritinemia is often found in patients with chronic hepatitis C (CHC) and is predictive of poorer response to antiviral therapy.
  
  
  OBJECTIVE
  To investigate changes in ferritinemia during and after antiviral therapy.
  
  
  METHODS
  serum ferritin levels were measured in 262 CHC patients (163 males, mean age 48.5 years +/- 10.1) before and during antiviral therapy, and six months post-treatment in all 154 patients with undetectable serum HCV-RNA after therapy completion.
  
  
  RESULTS
  Baseline serum ferritin was higher in patients with primary therapeutic failure than in those reaching sustained viral response (330 +/- 291 ng/mL vs. 211 +/- 192 ng/mL, p = 0.002). Serum ferritin transiently increased during therapy from baseline (257 +/- 242 ng/mL vs. 875 +/- 630 ng/mL, p < 0.001). Six months after finishing therapy, serum ferritin decreased under baseline values both in sustained responders (117 +/- 102 ng/mL vs. 211+/- 192 ng/mL, p < 0.001) and, to a lesser extent, in relapsers (217 +/- 174 ng/mL vs. 257 +/- 221 ng/mL, p = 0.047).
  
  
  CONCLUSIONS
  Baseline serum ferritin may predict response to antiviral treatment in chronic hepatitis C. Combined antiviral therapy induces a marked increase in serum ferritin that falls below baseline values after sustained viral response, suggesting that the cause of hyperferritinemia in many patients is HCV infection itself rather than iron overload.
authors.affiliation: Services of Gastroenterology (Liver Unit), Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain. jladero.hcsc@salud.madrid.org
authors.forename: J M
authors.initials: JM
authors.lastname: Ladero
authors.forename: G
authors.initials: G
authors.lastname: López-Alonso
authors.forename: M J
authors.initials: MJ
authors.lastname: Devesa
authors.forename: F
authors.initials: F
authors.lastname: Cuenca
authors.forename: L
authors.initials: L
authors.lastname: Ortega
authors.forename: M
authors.initials: M
authors.lastname: Agreda
authors.forename: A
authors.initials: A
authors.lastname: Suárez
authors.forename: P
authors.initials: P
authors.lastname: Ropero
authors.forename: M
authors.initials: M
authors.lastname: Díaz-Rubio