Serum Iron, Serum Ferritin and Hepatic Iron Content as a Predictive Values for Combined Therapy of Chronic Hepatitis C Patients

El-Kholy, NM; Saleh, BM; Ragab, SH; Khalil, AM; El-Shazly, SH; El-Hosary, YA

doi:10.21608/ejhm.2003.18723

Serum Iron, Serum Ferritin and Hepatic Iron Content as a Predictive Values for Combined Therapy of Chronic Hepatitis C Patients

Document Type : Original Article

Authors

¹ Tropical Medicine, Faculty of Medicine for Girls Al Azhar University

² Medicine Liver Institute, Menofeya University

³ Clinical Pathology National Research Center

⁴ Pathology Department Cairo University

10.21608/ejhm.2003.18723

Abstract

This Study was carried out on 40 patients with chronic hepatitis C virus who were selected with special inclusion criteria. All cases were subjected to evaluation by liver function tests (especially transaminases), HCV RNA (by PCR quantitative method), serum iron and serum ferritin. Liver biopsy was taken for histopathological study and detection of iron content. According to hepatic iron staining in liver biopsies of the 40 patients, the patients were classified into 4 groups (0, I, II, III hepatic iron grade) (20, 10, 8, 2 cases) respectively. All the patients were subjected to combined therapy (ribavirin and interferon alpha 2b) for 6 ms. then the patients were evaluated for the biochemical response (AST, ALT) virological response (HCV RNA viraemia) and histopathological response. Also serum iron, Serum ferritin and hepatic changes were estimated. This study revealed that there was a statistical significant difference in hepatic iron grade 0, I and II with no statistical significant difference in grade III hepatic iron as regards AST and ALT before and after the therapy. Also there was statistical significant difference in serum ferritin before and after therapy only in grade 0 and I hepatic iron although there was no significant difference found as regard serum iron level changes in all grades of hepatic iron before and after therapy. For the virological response there was a statistical significant difference as regards undetectable viraemia after therapy in total patients (30%) and in patients with hepatic iron grade 0 (45%) while no significant difference found in patients with grade I hepatic iron (30%), although no patients were found to have undetectable viraemia after therapy in grade II and III hepatic iron. For the histopathological response there was a statistical significant improvement of necroinflammatory activity score in hepatic iron grades 0, I and II while no significant improvement found in hepatic iron grade III after the course of the treatment compared to baseline biopsies (before the treatment) Also for the changes of fibrosis stages after therapy, there was no significant improvement in total cases and in patients with different hepatic iron grades. Out of 20 patients with hepatic iron staining (grades I, II, III) before therapy, only in 4 cases improved the hepatic iron staining after therapy with no statistical significant change.