Viral eradication restores normal iron status in chronic hepatitis C patients with abnormal iron studies

Abstract

Introduction and objectives: Abnormal serum iron studies are seen in a third or more of patients with chronic hepatitis C infection (HCV), where they have been linked to accelerated fibrosis progression and increased risk of hepatocellular carcinoma and sometimes lead to concern for coexisting hereditary hemochromatosis. The aim of this study was to assess the effect of HCV eradication in patients with abnormal serum iron studies prior to treatment with direct-acting antiviral agents (DAAs). Patients: HCV-infected subjects with iron studies obtained before and after successful treatment with DAAs were identified (n = 27). All had one or more abnormal iron test before treatment. Results: Following HCV eradication, serum iron, transferrin-iron saturation and ferritin levels decreased significantly (pre- versus post-treatment, p 90% and/or serum ferritin >1000 ng/mL. Elimination of HCV infection was associated with a significant reduction in post-treatment ferritin levels even among subjects whose ferritin levels were within normal limits at baseline. Risk factors for other conditions associated with abnormal iron status were present in the few cases in which iron studies failed to normalize following DAA treatment. Conclusions: Eradication of HCV infection restores normal iron status in most patients with abnormal iron tests, including those whose baseline parameters are suggestive of hemochromatosis.

Keywords

• Antiviral agents
• Hemochromatosis
• Hepatitis C
• Iron
• Sustained virologic response