Iron reduction as an adjuvant to interferon therapy in patients with chronic hepatitis C who have previously not responded to interferon: A multicenter, prospective, randomized, controlled trial

Adrian M. Di Bisceglie*, Herbert L. Bonkovsky, Sanjiv Chopra, Steven L Flamm, Rajender K. Reddy, Norman Grace, Paul Killenberg, Christine Hunt, Carlo Tamburro, Anthony S. Tavill, Roy Ferguson, Edward Krawitt, Barbara Banner, Bruce R. Bacon

*Corresponding author for this work

Research output: Contribution to journalArticle

148 Scopus citations

Abstract

Hepatic iron concentration has consistently been observed as being directly correlated with the response to interferon therapy in chronic hepatitis C virus (HCV). We therefore conducted a randomized, controlled trial comparing iron reduction by phlebotomy with iron reduction followed by retreatment with interferon in 96 patients with chronic hepatitis C who had previously not responded to a course of interferon. During the initial phase when all patients were undergoing phlebotomy, we found that serum alanine transaminase (ALT) activities decreased but by less than 50% from baseline in 67 patients (89%), decreased by more than 50% in 12 patients (13%) and became normal in 9 patients (9%) with no overall change in HCV-RNA levels. Subsequently no patient in either treatment group achieved a sustained virologic response. Improvements in necroinflammatory changes were noted in liver biopsy specimens in those patients receiving phlebotomy plus interferon (mean index 8.59 vs. 7.37, P < .05). A slight but not statistically significant decrease in histologic activity index was noted in those subjects treated by phlebotomy alone (mean index 8.4 vs. 7.75, P not significant). We conclude that, although prior phlebotomy therapy does not improve the rate of sustained response to interferon retreatment, it does result in less liver injury manifested by a decrease in serum transaminase activity and a slight improvement in liver histopathology.

Original languageEnglish (US)
Pages (from-to)135-138
Number of pages4
JournalHepatology
Volume32
Issue number1
DOIs
StatePublished - Jan 1 2000

ASJC Scopus subject areas

  • Hepatology

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    Di Bisceglie, A. M., Bonkovsky, H. L., Chopra, S., Flamm, S. L., Reddy, R. K., Grace, N., Killenberg, P., Hunt, C., Tamburro, C., Tavill, A. S., Ferguson, R., Krawitt, E., Banner, B., & Bacon, B. R. (2000). Iron reduction as an adjuvant to interferon therapy in patients with chronic hepatitis C who have previously not responded to interferon: A multicenter, prospective, randomized, controlled trial. Hepatology, 32(1), 135-138. https://doi.org/10.1053/jhep.2000.8700