Back to Search
Start Over
Serum ferritin as a predictor of treatment outcome in patients with chronic hepatitis C
- Source :
- Università degli studi di Modena e Reggio Emilia-IRIS
- Publication Year :
- 2009
-
Abstract
- OBJECTIVES: Antiviral treatment in chronic hepatitis C (CHC) involves ribavirin, a hemolytic agent. We planned a prospective study to evaluate whether drug-induced iron perturbation is clinically relevant as it relates to therapeutic outcome. METHODS: Iron variables were sequentially assessed in 206 CHC patients undergoing antiviral therapy and were correlated with pretreatment iron status and histology, hemolysis, and therapeutic outcome. RESULTS: At week 1 of therapy, serum iron (SI), transferrin saturation (TS), and serum ferritin (SF) increased markedly in all patients. All iron parameters correlated with hemolysis up to week 4; this correlation was lost for SF at later time points. SF rise during treatment was inversely related to baseline SF and iron deposits in hepatic mesenchymal/Kupffer cells. Both baseline SF and mesenchymal iron significantly correlated with fibrosis at multivariate analysis (P=0.015 and 0.008, respectively). Interestingly, baseline SF, despite good specificity (89%), had low sensitivity in predicting siderosis (25%). During therapy, SI, TS, and hemolysis parameters did not correlate with sustained virological response (SVR), whereas SF rise became an independent predictor of therapeutic response: a 2.5-fold increase of SF at week 12 associated with higher likelihood of SVR (odds ratio 1.91, P=0.032). Accordingly, lack of mesenchymal iron deposits at the baseline biopsy correlated with SVR (odds ratio 3.02, P=0.043). CONCLUSIONS: In CHC, SF is a useful marker for assessing disease duration and progression before starting treatment and for predicting therapeutic response while on therapy. SF rise during antiviral therapy is largely independent of hemolysis and likely indicates activation of macrophages in response to antivirals.
- Subjects :
- Male
Gastroenterology
Polyethylene Glycols
chemistry.chemical_compound
Blood serum
antiviral therapy
chemistry.chemical_classification
medicine.diagnostic_test
biology
Transferrin
Hepatitis C
Middle Aged
Iron metabolism
Recombinant Proteins
Treatment Outcome
Liver
HCV
Disease Progression
Serum iron
Female
Adult Antiviral Agents/*therapeutic use Disease Progression Female Ferritins/*blood Hemolysis/drug effects Hepatitis C
Chronic/*blood/drug therapy/pathology Humans Interferon Alfa-2a/therapeutic use Iron/blood Liver/pathology Male Middle Aged Polyethylene Glycols/therapeutic use Ribavirin/therapeutic use Transferrin/analysis Treatment Outcome
Siderosis
Adult
medicine.medical_specialty
Iron
Interferon alpha-2
Antiviral Agents
Hemolysis
Serum ferritin
Ferritin
Ribavirin
Internal medicine
medicine
chronic hepatitis C
Humans
Hepatology
Transferrin saturation
business.industry
Interferon-alpha
Hepatitis C, Chronic
medicine.disease
chemistry
Ferritins
Immunology
biology.protein
hepatitis C
ferritin
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Università degli studi di Modena e Reggio Emilia-IRIS
- Accession number :
- edsair.doi.dedup.....abf86adb8c14324a276b77ad369f8306