Gastroenterology and Hepatology from Bed to Bench

Abstract

Aim: To investigate if hepatic iron content influences the response to therapy in patients with chronic hepatitis C or B.

Background: It seems that the presence of elevated body iron stores and, in particular, elevated hepatic iron levels, is one of the strongest predictors of resistance to interferon treatment for chronic hepatitis C or B.

Patients and methods: Two hundred and one patients with chronic hepatitis C or B who were referred to Tehran Hepatitis Center were enrolled in this study. Histological quantification of hepatic iron was carried out by scoring iron separately within hepatocytes, sinusoidal cells, and portal triads. To estimate a cut off point for iron deposit as a predictor of response to treatment, Odd´s ratio with 95% confidence interval was calculated for each level of iron deposit.

Results: Iron scores were divided into two levels of high and low at several cut-off points, but the most significant differences were found when score 2 was considered as the cut-off point.  Odd's ratios were not significant in any of the hepatic zones. The lowest P-values were related to zone II sinusoidal cells and the total of sinusoidal cells and portal iron score (P= 0.08) in which the Odd's ratios were 6 (95% CI, 0.77 to 46.6) and 3.9 (95% CI, 0.88 to 17.4) respectively.

Conclusion: In our society, liver iron content cannot be considered as an important risk factor of resistance to treatment in chronic hepatitis patients because of the very small prevalence. So, hepatic iron measurement and scoring do not seem cost-effective and valuable for all patients with chronic hepatitis in our population.