Iron stores, response to alpha-interferon therapy, and effects of iron depletion in chronic hepatitis C.
Piperno A, Sampietro M, D'Alba R, Roffi L, Fargion S, Parma S, Nicoli C, Corbetta N, Pozzi M, Arosio V, Boari G, Fiorelli G
Istituto di Scienze Biomediche, Cattedra di Medicina Interna, Ospedale S. Gerardo dei Tintori, Monza e Universita degli Studi di Milano, Italy.
We studied 81 patients with chronic hepatitis C to investigate the relationship between iron and alpha-interferon response. Sixty-one patients (group A) were given alpha-interferon irrespective of iron status, whereas 20 (group B) with iron overload, were iron depleted before alpha-interferon therapy. In group A, 21 patients responded to alpha-interferon and 40 were non-responders. Increased iron indices were significantly more frequent in non-responders than responders. Multivariate analysis showed that among the independent variables evaluated, only gamma-GT and liver iron concentration predicted therapy outcome. After phlebotomy treatment, serum alanine aminotransferase fell significantly both in patients of group B (196 +/- 122 IU/l vs 82 +/- 37 IU/l, p < 10(-6)) and in 12 non-responders of group A (198 +/- 89 IU/l vs 107 +/- 81 IU/l, p < 10(-6)). In 16 iron depleted patients, eight from each group, subsequent treatment with alpha-interferon produced a response in only one patient. These results suggest that increased liver iron is a negative prognostic factor for alpha-interferon response in chronic hepatitis C. Iron depletion had a beneficial effect on serum alanine aminotransferase in all the patients treated, but did not improve the response to alpha-interferon.
PMID: 8877995, UI: 97032099
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