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 24 January 2018

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News

Hepatic iron overload does not prevent sustained virological response to interferon therapy

A long-term response to interferon-alpha is unrelated to hepatic iron concentration in patients with transfusion-acquired iron overload, who have beta-thalassemia major and chronic hepatitis C infection, according to researchers from Melbourne, Australia.

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The team evaluated the effect of hepatic iron concentration (HIC) on response to interferon monotherapy in patients with massive hepatic iron overload.

They published their results in the April issue of the American Journal of Gastroenterology.

Transfusion-acquired chronic hepatitis C infection and systemic iron overload are common in patients with beta-thalassemia major.

The magnitude of hepatic iron overload has been associated with a poor response to interferon-based antiviral therapy for hepatitis C.

Some 28 patients with beta-thalassemia major, transfusion-acquired iron overload, and chronic hepatitis C infection were prospectively treated with interferon for 6 months.

HIC was measured by atomic absorption spectroscopy before treatment.

Serum iron, ferritin, hepatitis C virus genotype, viral load, and liver histology were all analyzed.

Eight patients (28%) achieved a sustained virological response that was durable after a mean of 66 months of follow-up.

No difference in hepatic iron concentration between interferon responders and nonresponders.
American Journal of Gastroenterology
The median HIC was 2583 µg/g dry weight.

There was no difference in HIC between responders and nonresponders to therapy.

The authors found that serum hepatitis C virus RNA was lower in responders than in nonresponders.

Furthermore, genotype 1 was more frequent in nonresponders, and non-1 genotypes were more frequent in responders, although this did not reach statistical significance because of patient numbers.

Dr William Sievert, of the Monash Medical Centre, Melbourne, said on behalf of fellow colleagues, "A long-term response to interferon is unrelated to HIC in this patient group, and a durable response can occur despite massive iron overload."

"HIC may be a factor in liver cell injury, but it does not reliably predict a response to interferon therapy," he concluded.

Am J Gastroenterol 2002; 97(4): 982-8
19 April 2002

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