Hepatic iron concentration does not predict response to standard and pegylated-IFN/ribavirin therapy in patients with chronic hepatitis C
Hepatic iron concentration does not predict response to standard and pegylated-IFN/ribavirin therapy in patients with chronic hepatitis C
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DOI：
10.1016/s0168-8278(04)00127-8
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发表时间：
2004-06-01
影响因子：
25.7
通讯作者：
Ferenci, P
中科院分区：
文献类型：
--
作者：
Hofer, H;Österreicher, C;Ferenci, P
背景/目的：铁超载在慢性丙型肝炎(CHC)患者中很常见。方法：对169例干扰素初治的慢性丙型肝炎患者(男性115例，女性54例，年龄40.8±10.7岁)进行肝活检。常规干扰素/利巴韦林治疗140例，聚乙二醇化干扰素/利巴韦林治疗29例。活检标本根据DiBisceglie评分系统和铁分级进行评估。用原子吸收光谱法测定HIC。基线检测铁蛋白和转铁蛋白饱和度以及HFe-C282Y和H63D基因突变的存在。结果：联合治疗无效者血清铁蛋白水平在基线水平较高(p<；0.01)。HIC、转铁蛋白饱和度和HFE突变状态在应答者和无应答者之间没有差异。Logistic回归分析显示血清铁蛋白是反应的独立预测因子。HIC与DiBisceglie评分(r=0.352，p<；0.001)、铁分级(r=0.352，p<；0.001)、血清铁蛋白(r=0.335，p<；0.001)呈正相关。相反，高基线血清铁蛋白水平是抗病毒治疗反应差的预测指标。(C)2004年欧洲肝脏研究协会。爱思唯尔出版，版权所有。
Background/Aims: Iron overload is common among patients with chronic hepatitis C (CHC). In this study the role of hepatic iron concentration (HIC) and serum iron parameters was assessed to determine response to standard and pegylated interferon (IFN)/ribavirin combination therapy in patients with CHC.Methods: Liver biopsies were obtained from 169 IFN-naive patients (m = 115, f = 54, age: 40.8 +/- 10.7) with CHC. 140 patients were treated with standard IFN/ribavirin, 29 patients with pegylated-IFN/ribavirin. Biopsy specimens were evaluated according to the DiBisceglie scoring system and iron grading. HIC was determined by atomic absorption spectroscopy. Ferritin and transferrin saturation and presence of HFE-C282Y and H63D gene mutations were determined at baseline.Results: Nonresponders to combination therapy had higher serum ferritin levels at baseline (p < 0.01). There was no difference of HIC, transferrin saturation levels, and the HFE-mutation status between responders and nonresponders. Logistic regression analysis revealed serum ferritin as an independent predictor of response. HIC correlated with the DiBisceglie score (r = 0.352, p < 0.001), iron grading (r = 0.352, p < 0.001) and serum ferritin (r = 0.335, P < 0.001).Conclusions: Pretreatment liver iron concentration does not predict response to combination therapy in patients with CHC. In contrast, high baseline serum ferritin levels are predictors of poor response to antiviral therapy. (C) 2004 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.