Hepatic iron concentration does not predict response to standard and pegylated-IFN/ribavirin therapy in patients with chronic hepatitis C*1

Differentiation of nonalcoholic from alcoholic steatohepatitis: are routine laboratory markers useful?

“…Similarly, the significant differences for ferritin between NASH and ASH patients probably reflect underlying inflammatory activity, as in patients with hepatitis C [36].…”

Iron and hepatitis C

“…These studies suggest that an HIC above 1100 µg/g is associated with nonresponse to interferon alpha therapy in greater than 80% of cases, and has been proposed as a predictive threshold above which failure of interferon monotherapy is likely [24,33]. In contrast, recent studies have shown that HIC does not correlate with response to interferon/ribavirin or pegylated interferon/ ribavirin combination therapy [10,27,34]. These results indicate that the addition of ribavirin to the HCV therapeutic regimen is able to offset the detrimental effects of high HIC on the success of interferon monotherapy.…”

“…Although the extent of this relationship needs further study, the concept that serum iron markers are correlated to disease progression has been proposed for several other diseases [23]. Furthermore, serum iron markers, and in particular ferritin, have been found to predict a negative response to interferon monotherapy [24][25][26][27] and interferon/ribavirin or pegylated interferon/ribavirin combined therapy [8,10]. Lastly, the highest level of ferritin has been observed in patients infected with HCV genotype 1b, which is also the genotype that is associated with higher disease severity and resistance to interferon therapy [4].…”

The Role of Iron in Hepatitis C Infection

“…Four studies have evaluated the relationship between quantitative measurement of hepatic iron content and the success rate of anti viral therapy with combination interferon and ribavirin [9-11, 12•], and two of the four have reported no relationship [9,10]. That is, there was no difference in the hepatic iron content in responders and nonresponders.…”

“…Rulyak did not compare standard and peg IFN patients separately [9], while Hofer did compare the patients receiving the two different types of IFN separately but did not specify how many patients were in each group [10].…”