A pilot randomized, controlled trial of the effect of iron depletion on long-term response to α-interferon in patients with chronic hepatitis C

Autor: Masashi Mizokami, Allan G. Redeker, Charles G. Phan, Kimberly Goad, Steven Han, Timothy R. Morgan, Naoky Tsai, Tse-Ling Fong, Dajun QianP
Rok vydání: 1998
Předmět:
Zdroj: Journal of Hepatology. 28:369-374
ISSN: 0168-8278
DOI: 10.1016/s0168-8278(98)80308-5
Popis: Background/Aims: Some studies have suggested that hepatic iron may influence the response to interferon therapy in chronic hepatitis C patients. We conducted this randomized, controlled trial to evaluate the effect of iron depletion on: (1) aminotransferase activity and hepatitis C RNA levels; and (2) response to interferon therapy in 38 patients with elevated alanine aminotransferase levels and who were HCV RNA positive. Methods: Seventeen patients underwent a 500-ml phlebotomy every 2 weeks until iron deficiency was achieved. Patients were then started on a 6-month course of α-interferon 2b (3 mu tiw). Controls were 21 patients who were monitored for 6- to 8-week period without phlebotomy prior to interferon therapy. Response to interferon was defined as loss of serum HCV RNA by reverse transcriptase-polymerase chain reaction. Serum HCV RNA was quantitated by bDNA technique. Results: Alanine aminotransferase levels decreased in 1517 patients after phlebotomy. Mean alanine aminotransferase fell from 156.8 to 89.7 U/l ( p =0.008). Changes in iron indices and alanine aminotransferase after phlebotomy were not accompanied by changes in HCV RNA levels. In control patients, neither alanine aminotransferase nor HCV RNA levels changed during the observation period. At the end of 24 weeks of interferon therapy, sol:717 phlebotomized patients had a response, compared to 621 control patients ( p =ns). After 6 months of follow-up, 517 phlebotomized patients remained HCV RNA negative, in contrast to only 121 controls ( p =0.07). Conclusions: Iron depletion led to a reduction in aminotransferase levels; this was not accompanied by changes in levels of hepatitis C RNA. There may be an improvement in the sustained response to interferon therapy, but this requires confirmation.
Databáze: OpenAIRE
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