Introduction
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Iron overload and chronic HCV infection
The effect of iron depletion on liver status in chronic HCV infection
Author [ref] | Number of patients | Characteristics | Results |
---|---|---|---|
Hayashi et al. [40] | 40 | 40 naïve | Phlebotomy significantly reduced mean ALT levels |
Sartori et al. [42] | 24 | 12 IFN NR, 12 naïve | Reduction of ALT levels and inflammatory grading score, suppression of the progression of staging score for fibrosis |
Yano et al. [43] | 33 | NI | Phlebotomy significantly reduced ALT |
Tanaka et al. [44] | 22 | NI | Phlebotomy significantly reduced ALT, AST, and α-fetoprotein levels |
Yano et al. [47] | 25 | 22 IFN NR, 3 naïve | Reduction of ALT levels, improvement of liver inflammation, and suppression of the progression of liver fibrosis |
Alexander et al. [48] | 18 | 18 NR | Biochemical response was accompanied by a reduction of markers of fibrogenesis |
The effect of iron depletion on response to antiviral therapy
Author [ref] | Number of patients | Characteristics | Results |
---|---|---|---|
(a) Iron depletion before IFN therapy
| |||
Piperno et al. [41] | 16 | 8 IFN NR, 8 naïve | Iron depletion decreased ALT levels but did not improve SVR to IFN |
Herrera [46] | 28 | 28 IFN NR | No patient achieved an SVR |
Guyader et al. [53] | 16 | 16 IFN NR | Despite a significant effect on serum ALT levels, no effect on viremia was observed |
Tsai et al. [54] | 20 | 20 IFN NR | IFN retreatment preceded by iron depletion produced a 15% of SBR and SVR |
Di Bisceglie et al. [55] | 96 | 96 IFN NR | No patient achieved an SVR |
Fargion et al. [56] | 114 | 114 naïve | Iron removal by phlebotomy improved the rate of SVR to IFN |
Carlo et al. [57] | 83 | 83 IFN naïve | Iron removal by phlebotomy improved serum ALT levels and the rate of SVR to IFN |
(b) Iron depletion plus IFN
| |||
Van Thiel et al. [58] | 30 | 30 IFN NR | Combination therapy increased SVR (60% vs. 13% in the IFN-alone group) |
Fong et al. [59] | 38 | 38 IFN naïve | Combination therapy increased SVR (29% vs. 5% in the IFN-alone group) |
Fontana et al. [60] | 82 | 82 IFN naïve | Combination therapy improved virologic and histological response to IFN |