Hepatitis C and iron

Hepatitis C is the commonest form of chronic viral hepatitis in most western countries. A significant proportion of patients develop cirrhosis, hepatic failure and hepatocellular carcinoma. The results of controlled trials have shown that interferon alpha is an effective treatment for hepatitis C. Treatment results in normalization of elevated transaminase levels in up to 50% of patients, although only 15-25% of patients have a sustained response. Recent studies have shown that iron influences the response of chronic hepatitis C to treatment and the natural history of hepatitis C. The mechanisms responsible for the effects of iron are not clear but emerging data suggest that the cellular location of iron within the liver lobule and the subsequent effects on immune function are likely to be critical determinants for these effects. It is likely that therapies for chronic hepatitis C which either remove iron or interfere with the action of iron at the cellular level may not only prove useful clinically but may also elucidate further the mechanisms of cellular injury in this disease.