Hepatic Iron Staining In Chronic Hepatitis C Patients With Low Hcv Rna Levels As A Predictive Marker For Interferon Therapy

Objectives: Interferon (lFN) therapy is ineffective in about 20%-30% of chronic hepatitis C (CH-C) patients with low hepatitis C virus (HCV) RNA levels. Besides the serum HCV RNA level or HCV genotype, hepatic iron concentrations are thought to be correlated with the subsequent response to IFN therapy. In the present study, we evaluated serum iron, ferritin, and hepatic iron staining in patients with low HCV RNA levels as a predictive marker for IFN therapy. Methods: We evaluated 75 CH-C patients whose serum HCV RNA levels were below 1 million genome equivalent/ml as shown by a branched DNA signal amplification assay. Results: There were no significant differences with regards to age, sex, serum alanine aminotransferase levels, or serum iron concentrations between responders and nonresponders. The total iron score (TIS) was significantly higher in responders (P < 0.01), and multivariate analysis showed that TIS was an independent factor relating to the response to IFN therapy (P = 0.0062). The TIS correlated significantly with serum ferritin levels (r = 0.637, P < 0.001), but not with any other parameter. Conclusions: Among CH-C patients with low HCV RNA levels, the TIS of the liver may be used as a predictive marker for IFN therapy.