Raised serum ferritin predicts non-response to interferon and ribavirin treatment in patients with chronic hepatitis C infection

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Abstract

Liver

Volume 22 Issue 3 Page 269 - June 2002

Raised serum ferritin predicts non-response to interferon and

ribavirin treatment in patients with chronic hepatitis C infection

Distante S1, Bjøro K2, Hellum KB3, Myrvang B4, Berg JP5, Skaug K6,

Raknerud N7 and Bell H1

Background/Aim:

Previous studies have indicated that response to interferon therapy

is inversely proportional to the amount of body iron stores. We have

studied the relationship between serum ferritin, transferrin

saturation, liver iron, presence of HFE-C282Y gene mutation and

response to treatment in patients with chronic hepatitis C infection.

Methods:

Two hundred and fifty-six naive, HCV-RNA positive patients (60%

males, median age 38years, range 21-70) were treated with interferon

and ribavirin for 6months. Iron indices and the presence of the C282Y

mutation were measured. In 242 (94%) patients iron deposition were

determined by Perls staining method. Patients with negative HCV-RNA

at 6months after the end of treatment were defined as sustained viral

responders.

Results:

Non-responders (n=127) had significantly higher median s-ferritin

values compared with sustained viral responders (130µg/L vs. 75µg/L

P<0.001). There was no difference in transferrin saturation among the

two response groups. Only 23% (4/7) of patients with Perls grade 1 in

liver biopsies responded to treatment vs. 54% (122/225) patients

without iron deposition (P=0.02), however, 10/13-non-responders had

HCV genotype one. Two patients (0.8%) were homozygous for the C282Y

mutation, 36 patients were heterozygous (14%). Among mutation

carriers 26/38 achieved sustained response compared with 102/216

non-carriers (68% vs. 48%, P=0.02). In a multivariate analysis

s-ferritin (P=0.030) and C282Y carrier status (P=0.012) remained

independent predict of sustained response.

Conclusions:

Raised s-ferritin values predicate non-response to

interferon-ribavirin therapy in hepatitis C patients. Response rate

in C282Y mutation carriers seems greater than in non-carriers.

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