Relationships between hepatic iron content and virologic response in chronic hepatitis C patients treated with interferon and ribavirin.
The aims of this study were to determine the effect of pretreatment hepatic iron concentration (HIC) on response to combination therapy with interferon and ribavirin, and to examine the change in HIC associated with this treatment.Patients with hepatitis C who underwent liver biopsy before and after combination therapy were studied retrospectively. HIC was measured from paired pre- and posttreatment liver biopsy specimens, and histologic grade and stage were recorded.Sixty of 112 (54%) patients achieved sustained virologic response (SVR); response varied by genotype (genotype 1 (44%), genotype 2 or 3 (85%)). There was no difference in pretreatment median HIC between responders and nonresponders (404 microg/g and 394 microg/g, respectively; p= 0.31); patients with HIC > or = 500 microg/g were not less likely to achieve SVR (OR = 1.1; 95% CI 0.5-2.3). In a multivariate analysis, factors associated with SVR included genotype 2 or 3 (OR = 12.2; 95% CI 3.1-47.8) and viral load < 2 million copies/ml (OR = 3.6; 95% CI 1.3-10.0). HIC > or = 500 microg/g did not decrease the likelihood of SVR (OR = 0.8; 95% CI 0.3-2.1). There was no significant change in HIC after combination therapy (median increase in HIC = 29.5 microg/g), and the change in HIC did not differ between responders and nonresponders (p= 0.73).Pretreatment HIC is not an independent predictor of response to therapy with interferon and ribavirin. Combination therapy does not significantly change HIC regardless of baseline histology or virologic response.
Rulyak, SJ; Eng, SC; Patel, K; McHutchison, JG; Gordon, SC; Kowdley, KV
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