Absolute iron deficiency is treated by correcting the causative lesion and then, traditionally, administering sufficient amounts of ferrous salt to return the haemoglobin level to normal and replenish body stores. The bioavailability of ferric compounds has been questioned and accordingly their therapeutic role remains controversial. A special problem is posed by regular blood donation, where the frequency of phlebotomy is limited by the haemoglobin level, which, in turn, requires maintenance of an adequate supply of iron from dietary sources. Since this latter situation may not always occur, it would be of practical benefit to have a form of supplementation that is effective and can be taken without side effects. These issues were prospectively examined in a consecutive series of otherwise healthy blood donors who developed absolute iron deficiency anaemia and were then randomly allocated to receive 60 mg of this metal as ferrous sulphate twice a day (Group 1: n = 51), 100 mg as chewable ferric polymaltose daily (Group 2: n = 53), or the latter product twice a day (Group 3: n = 55). Serial studies showed that 80% of patients in Groups 1 and 3 had reached normal haemoglobin levels by 12 weeks, but this figure was only 50% in Group 2. Similarly, the proportion of patients improving their percentage saturation of transferrin to within the normal range was significantly better in Groups 1 and 3 than in Group 2 (P < .01). However, body iron stores, reflected in serum ferritin level, was significantly better in Group 1 (P < .01); there was no difference in this respect between Groups 2 and 3.(ABSTRACT TRUNCATED AT 250 WORDS)

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Objectives: To define demographic and epidemiological features of an Australian population with chronic hepatitis C virus (HCV) infection and determine predictors of histological and clinical outcome. Design: Cohort study. Patients and setting: 342 consecutive HCV antibody‐positive patients referred to the liver clinic of a major metropolitan general hospital. Outcome measures: Demographic data, serial alanine aminotransferase (ALT) levels, full blood count for all patients. Percutaneous liver biopsy in 152 patients (44%). Results: 51% of patients had previously used injecting drugs, 15% had received a blood transfusion and 27% had no definite percutaneous risk factor (sporadic group). The injecting drug users (IDUs) were younger and more likely to have been born in Australia. The sporadic group were older and frequently were born in Mediterranean or Asian countries. A history of excessive alcohol use was common, particularly among IDUs (60%). Of 152 patients who had a liver biopsy, 49 had cirrhosis and 103 had chronic hepatitis. Some patients with a normal ALT level had marked necro‐inflammatory activity. On univariate analysis, the presence of cirrhosis correlated with older age (P < 0.0001), lack of an identifiable risk factor (P < 0.001) and birth in a Mediterranean or Asian country (P < 0.0001). On multivariate analysis, the only significant predictor of cirrhosis was age (P < 0.001). Among patients with an identifiable percutaneous risk factor, cirrhosis was seen at a median time of 18 years after first exposure to risk, compared with 13 years in patients with chronic hepatitis (P < 0.01). Patients with clinical evidence of portal hypertension were, on average, 15 years older than those with histological cirrhosis only (P < 0.01). Conclusions: Injecting drug use is the major risk factor for chronic HCV infection in Australia. In patients with an identifiable risk factor, the most significant factor associated with a biopsy finding of cirrhosis is the time since first exposure to HCV.

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