Correlation between Serum Iron Markers and Liver Fibrosis in Treatment-Naive Urban Patients with Chronic Hepatitis C Infection in Vajira Hospital
Kanjanadecha W, MD1, Sethasine S, MD1
Affiliation : 1 Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
Objective : To study the correlation between serum iron markers and liver fibrosis in treatment-naive chronic hepatitis C urban
patients.
Material and Methods: Fifty patients with treatment-naive chronic hepatitis C from database (E-phis) in the Liver Clinic from
January to December 2017, aged between 18 to 80 years, were examined for serum iron markers, laboratory investigations and
measurement of the liver stiffness.
Results : Eleven patients (22%) had normal serum aspartate aminotransferase (AST) and serum alanine aminotransferase (ALT)
levels. Thirty-four patients (68%) had a normal serum iron level, and 31 (62%) had a normal ferritin level. The mean serum levels
of iron (p = 0.003, p<0.001), ferritin (p = 0.020, p = 0.035) and transferrin saturation (p = 0.007, p = 0.015) showed significant
positive correlations with AST and ALT. The mean levels of AST, ferritin, total iron binding capacity (TIBC) and transferrin saturation
were significantly higher in patients of the significant fibrosis group than in the no/minimal fibrosis group (p = 0.013, 0.006, 0.049
and 0.030, respectively). Seventy-five percent of the patients with elevated serum ferritin had progressed to a stage of advanced
fibrosis. In the hepatocellular carcinoma group, the mean ferritin was significantly higher than in the non-HCC group (p = 0.010).
Conclusion : Serum ferritin was normal in all treatments-naive chronic hepatitis C with no-minimal fibrosis. Even with a low
sensitivity, a higher level may be useful to identify patients at risk of advanced fibrosis but not for necroinflammation. However, in
extremely high levels of ferritin, medical professionals need to beware of the possibility of hepatocellular carcinoma.
Keywords : Chronic hepatitis C infection, Serum iron markers, Liver stiffness
