Iron status parameters in patients with chronic hepatitis C virus infection

ABSTRACT

Hepatic iron deposition is common in patients with chronic hepatitis C [HCV] and may play a role in progression of liver disease. Aim of the present study was to determine the prevalence of iron overload and to study the relationship between hepatic iron concentration [HIC] and clinical, biochemical and histological characteristics in chronic HCV-infected patients. Patients presenting with anti-HCV and HCV-RNA were included. Hepatic iron concentration was determined in liver tissue by colormetric assay. The association between HIC and age, gender, transaminases [AST and ALT] levels, iron and serum ferritin, transferrin saturation, HCV-RNA level, grading of inflammatory activity, staging of fibrosis, hepatic steatosis, and stainable iron was analyzed. Statistical analysis included the Mann-Whitney test and a multiple linear regression model. 48 patients [58% male] with a mean age of 44 +/- 10 years were studied. Serum iron, ferritin and transferrin saturation were elevated in 27%, 25% and 12.5% of patients respectively. Stainable iron was detected in few patients [16.6%]. Higher grades of stainable iron [2 and 3] were observed in only 6.25%. The HIC >30mmol/g dry weight] was elevated in three patients [6.2%]. Neither grading nor staging were related to HIC. Higher HIC were observed in male patients [p <0.001], in patients with elevated serum ferritin [p = 0.001] and in patients with stainable iron [grade 1; p =0.001]. Multiple linear regression analysis showed that only stainable iron was independently correlated with HIC [p = 0.003]. Iron overload in chronically HCV-infected patients was uncommon and hepatic iron content seemed not to be related to the liver damage process. In the eventuality of iron overload, histochemical liver iron is a useful marker to estimate HIC