Chronic hepatitis C: hepatic iron content does not correlate with response to antiviral therapy

Chronic hepatitis C: hepatic iron content does not correlate with response to antiviral therapy

Alternative title Hepatite C crônica: concentração hepática de ferro não é correlacionada com a resposta ao tratamento antiviral
Author Pereira, Patrícia da Silva Fucuta Autor UNIFESP Google Scholar
Souza e Silva, Ivonete Sandra de Autor UNIFESP Google Scholar
Uehara, Silvia Naomi de Oliveira Autor UNIFESP Google Scholar
Emori, Christini Takemi Autor UNIFESP Google Scholar
Lanzoni, Valeria Pereira Autor UNIFESP Google Scholar
Silva, Antonio Eduardo Benedito Autor UNIFESP Google Scholar
Ferraz, Maria Lucia Cardoso Gomes Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract The complex interaction between hepatitis C virus infection, iron homeostasis and the response to antiviral treatment remains controversial. The aim of this study was to evaluate the influence of hepatic iron concentration (HIC) on the sustained virological response (SVR) to antiviral therapy in patients with chronic hepatitis C. A total of 50 patients who underwent pretreatment liver biopsy with assessment of HIC by graphite furnace atomic absorption spectroscopy and were subsequently submitted to antiviral treatment with interferon/peginterferon and ribavirin were included in the study. Patients with alcoholism, history of multiple blood transfusion, chronic kidney disease, hemolytic anemia and parenteral iron therapy were excluded. The iron related markers and HIC were compared between those who achieved an SVR and non-responders (NR) patients. The mean age was 45.7 years and the proportion of patients' gender was not different between SVR and NR patients. The median serum iron was 138 and 134 µg/dL (p = 0.9), the median serum ferritin was 152.5 and 179.5 ng/mL (p = 0.87) and the median HIC was 9.9 and 8.2 µmol/g dry tissue (p = 0.51), for SVR and NR patients, respectively. Thus, hepatic iron concentration, determined by a reliable quantitative method, was not a negative predictive factor of SVR in patients with chronic hepatitis C presenting mild to moderate hepatic iron accumulation.

A complexa interação entre infecção pelo vírus da hepatite C, homeostase do ferro e resposta ao tratamento antiviral permanece controversa. O objetivo deste estudo foi avaliar a influência da concentração hepática de ferro (CHF) na resposta virológica sustentada (RVS) à terapia antiviral na hepatite C crônica. Foram incluídos 50 pacientes que foram submetidos à biopsia hepática pré-tratamento com determinação da CHF por espectrofotometria de absorção atômica com forno de grafite e tratados posteriormente com interferon/peginterferon e ribavirina. Pacientes com alcoolismo, história de múltiplas transfusões sanguíneas, doença renal crônica, anemia hemolítica e terapia com ferro parenteral foram excluídos. O perfil de ferro sérico e a CHF foram comparados entre aqueles que atingiram RVS e os não-respondedores (NR). A média de idade dos pacientes foi 45,7 anos e não houve diferença na proporção de homens e mulheres entre os grupos RVS e NR. A mediana do ferro sérico foi 138 and 134 µg/dL (p = 0.9), a mediana da ferritina sérica foi 152,5 e 179,5 ng/mL (p = 0,87) e a CHF mediana foi 9,9 e 8,2 µmol/g de tecido seco (p = 0,51), para pacientes com RVS e NR, respectivamente. Concluindo, a concentração hepática de ferro, determinada por um método quantitativo confiável, não foi um fator preditivo negativo de RVS em pacientes com hepatite C crônica e acúmulo de ferro hepático leve a moderado.
Keywords Iron
Hepatitis C virus
Interferon
Peginterferon
Ribavirin
Liver biopsy
Language English
Date 2009-12-01
Published in Revista do Instituto de Medicina Tropical de São Paulo. Instituto de Medicina Tropical, v. 51, n. 6, p. 331-336, 2009.
ISSN 0036-4665 (Sherpa/Romeo)
Publisher Instituto de Medicina Tropical
Extent 331-336
Origin http://dx.doi.org/10.1590/S0036-46652009000600004
Access rights Open access Open Access
Type Article
SciELO ID S0036-46652009000600004 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/5405

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