Skip to main content

Elevated serum iron predicts poor response to interferon treatment in patients with chronic HCV infection

Digestive Diseases and Sciences volume 40, pages 2431–2433 (1995)Cite this article

Abstract

To date, there are no firm clinical, demographic, biochemical, serologic, or histologic features predicting which patients with chronic hepatitis C are more likely to respond to therapy with interferon-α. Serum iron, total iron-binding capacity, transferrin saturation, and ferritin were measured in the fasting state. The amount of stainable iron in liver biopsy specimens was evaluated histochemically as well. All patients received subcutaneous recombinant human IFN-α2a three million units thrice weekly by self-administration. Eleven of 13 (84%) responders had low to normal serum iron levels as compared to one of 26 (4%) nonresponders (P<0.001). The serum transferrin was similar in both groups, but iron saturation was significantly lower in responders (30±10%) than in nonresponders (53±12%) (P<0.001). Serum ferritin and hepatic iron content were higher in nonresponders (NS). It is suggested that increased serum iron and transferrin saturation blunt the action of interferon, as they have opposite effects on the immune system. Iron overload can thus lead to a poor response to interferon. It remains to be seen whether reducing iron overload will improve the response to interferon therapy.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Farthing MJC: Iron and immunity. Acta Pediatr Scand 361(s):44–52, 1989

    Google Scholar 

  2. De Sousa M, Breedvelt F, Dynesius-Trentham R, Trentham D, Lum J: Iron, iron-binding proteins and immune system cells. Ann NY Acad Sci 526:310–323, 1988

    PubMed  Google Scholar 

  3. Munn CG, Markenson AL, Kapadia A, De Sousa M: Impaired T cell mitogen responses in some patients with thalassaemia intermedia. Thymus 3:119–128, 1981

    PubMed  Google Scholar 

  4. Akbar AN, Fitzgerald-Bocarsly PA, De Sousa M, Giardina PJ, Hilgartner MW, Grady RW: Decreased natural killer activity in thalassaemia major: A possible consequence of iron overload. J Immunol 136:1635–1640, 1986

    PubMed  Google Scholar 

  5. De Sousa M: Blood transfusions and allograft survival: Iron related immunosuppression. Lancet 2:681–682, 1983

    Google Scholar 

  6. Di Bisceglie AM, Axiotis CA, Hoofnagle JH, Bacon BR: Measurements of iron status in patients with chronic hepatitis. Gastroenterology 102:2108–2113, 1992

    PubMed  Google Scholar 

  7. Olynyk J, Reddy R, DiBisceglie AM, Jeffers LJ, Parker T, Radick J, Schiff ER, et al: Hepatic iron concentration as a predictor of response to alpha interferon treatment in chronic hepatitis C. Hepatology 18:90A, 1993

    Google Scholar 

  8. Van Thiel DH, Friedlander L, Fagiuoli S, Wright HI, Irish W, Gavaler JS: Response to interferon α therapy is influenced by the iron content of the liver. J Hepatol 20:410–415, 1994

    PubMed  Google Scholar 

  9. Arber N, Konikoff F, Moshkowitz M, Hallak A, Halpern Z, Gilat T: Chronic hepatitis C virus infection is associated with increased serum iron, iron saturation and iron absorption, but no increased liver iron accumulation. Gastroenterology 104:872A, 1993

    Google Scholar 

  10. Ishak KG: New developments in diagnostic liver pathology.In Pathogenesis of Liver Diseases. IAP Monograph No. 28. Baltimore, Williams and Wilkins, 1987, pp 223–373

    Google Scholar 

  11. Rowe JW, Wands JR, Mezey E, Waterbury LA, Wright JR, Tobin J, Andres R: Familial hemochromatosis; characteristic of the precirrhotic stage in a large kindred. Medicine (Baltimore) 56:197–211, 1977

    PubMed  Google Scholar 

  12. Pignatelli M, Waters J, Brown D, Lever A, Iwarson S, Schaff Z, Gerety R, et al: HLA class I antigens on the hepatocyte membrane during recovery from acute hepatitis B virus infection and during interferon therapy in chronic hepatitis B virus infection. Hepatology 6:349–353, 1986

    PubMed  Google Scholar 

  13. Okada SI, Akahane Y: The degree of variability in the amino terminal region of the E2/NS1 protein of hepatitis C virus correlates with responsiveness to interferon therapy in viremic patients. Hepatology 16:619–624, 1992

    PubMed  Google Scholar 

  14. Marcellin P, Boyer N, Giostra E, Degott C, Courouce AM, Degoss F, Coppere H, et al: Recombinant human alfa-interferon in patients with chronic non-A, non-B hepatitis: A multicenter randomized controlled trial from France. Hepatology 13:393–397, 1991

    PubMed  Google Scholar 

  15. Arber N, Halpern Z, Hallak A, Konikoff F, Santo M, Moshkowitz M, Tiomny E, et al: Post transfusion etiology and non-cirrhotic histology improve the remission rate and reduce complications during interferon therapy in chronic HCV patients. Gastroenterology 104:872A, 1993

    Google Scholar 

  16. Perez R, Pravia R, Linares A, Rodriguez M, Lombrana JLS, Suarez A, Riestra S, et al: Response related factors in recombinant interferon alfa-2b treatment of chronic hepatitis C. Gut Suppl:S139–S140, 1993

Download references

Author information

Affiliations

  1. From the Departments of Gastroenterology and Pathology, Tel-Aviv Sourasky Medical Center, Ichilov Hospital and Sackler Faculty of Medicine Tel-Aviv University, Tel-Aviv, Israel

    Nadir Arber MD, Menachem Moshkowitz MD, Fred Konikoff MD, Zamir Halpern MD, Aharon Hallak MD, Moshe Santo MD, Elisa Tiomny MD, Mimi Baratz MD & Tuvia Gilat MD

Authors
  1. Nadir Arber MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Menachem Moshkowitz MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fred Konikoff MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zamir Halpern MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Aharon Hallak MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Moshe Santo MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Elisa Tiomny MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mimi Baratz MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tuvia Gilat MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Arber, N., Moshkowitz, M., Konikoff, F. et al. Elevated serum iron predicts poor response to interferon treatment in patients with chronic HCV infection. Digest Dis Sci 40, 2431–2433 (1995). https://doi.org/10.1007/BF02063249

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02063249

Key words

  • serum iron
  • interferon
  • hepatitis C