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Iron levels in hepatocytes and portal tract cells predict progression and outcomes of patients with advanced chronic
Richard W Lambrecht1, Richard K Sterling, Deepa Naishadham
1Department of Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA.
Gastroenterology
|February 22, 2011
Summary
Elevated iron in liver cells and portal tracts predicts worse outcomes in advanced hepatitis C. Pegylated interferon therapy did not alter iron levels or improve patient outcomes.
Area of Science:
- Hepatology
- Gastroenterology
- Internal Medicine
Background:
- Iron accumulation may impact non-hemochromatotic liver disease progression.
- The HALT-C Trial investigated long-term outcomes in patients with advanced chronic hepatitis C.
Purpose of the Study:
- To assess the relationship between iron levels, HFE gene variations, and disease progression in the HALT-C Trial.
- To determine if Pegylated Interferon (PegIFN) therapy influenced iron variables and clinical outcomes.
Main Methods:
- Randomized trial comparing PegIFN (n=400) versus no therapy (n=413) with long-term follow-up.
- Analysis of baseline and longitudinal iron variables, clinical outcomes, and HFE genotype using statistical models.
Main Results:
- Higher baseline stainable iron in hepatocytes and portal tracts correlated with adverse clinical outcomes (CTP > 7, ascites, HCC, death).
- Baseline iron in portal triads predicted increased risk of outcomes (HR=1.35).
- Hepatocyte iron decreased, while portal stromal cell iron increased over time; PegIFN did not affect stainable iron.
Conclusions:
- Stainable iron in hepatocytes and portal tracts is a significant predictor of progression and outcomes in advanced chronic hepatitis C.
- Chronic low-dose PegIFN therapy did not improve clinical or histological outcomes, nor did it impact iron variables.
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