Hepatic iron overload is common in chronic hepatitis B

StephenW

J Viral Hepat. 2012 Feb;19(2):e170-6. doi:
10.1111/j.1365-2893.2011.01508.x. Epub 2011 Sep 14.
Hepatic iron overload is common in chronic hepatitis B and is more severe in patients coinfected with hepatitis D virus.
Source:http://www.ncbi.nlm.nih.gov/pubmed/22239515
Sebastiani G, Tempesta D, Alberti A. SourceDigestive Diseases, Hepatology
and Clinical Nutrition Department, Dell'Angelo Hospital, Venice, Italy
Department of Histology, Microbiology and Medical Biotechnologies,
University of Padova, Padova, Italy.
Abstract Summary.
Hepatic iron overload has been described in chronic hepatitis C as a cofactor affecting
fibrosis progression. Data in patients with chronic hepatitis B infection
are scarce. We investigated hepatic iron deposits and serum iron indices in
205 consecutive patients with hepatitis B and compensated liver disease.
Mean age of the patients was 42.4 ± 12.4 years and 72.5% were males.
Coinfection with hepatitis delta virus (HDV) was present in 8.8%. At least
one of the serum iron indices was elevated in 41.5% of cases. Hepatic iron
deposits were detected in 35.1% of patients, most of them being minimal
(grade I) (59.7%) or mild (grade II) (27.8%). Variables significantly
associated with hepatic iron deposits were male gender (P = 0.001), serum
ferritin (P = 0.008), ?GT (P = 0.05) and alkaline phosphatase (P = 0.05)
levels. By multivariate analysis hepatic iron deposits correlated with
serum ferritin [odds ratio (OR) 1.2, 95% confidence interval (CI) 1.05-1.4,
P = 0.002]. Presence of mild-moderate (grades II and III) hepatic iron
deposits could be excluded with high negative predictive value (90%) when
serum ferritin was within normal values. A significant correlation between
coinfection with HDV and hepatic iron deposits was also found (OR 4.23, 95%
CI 1.52-11.82, P = 0.003). When compared to monoinfected cases, HDV
positive patients had more elevated ?GT (P = 0.03), more advanced fibrosis
and more severe iron deposits (P < 0.0001).
In conclusion, in well-compensated chronic hepatitis B infection, hepatic iron deposits and
elevation of serum iron indices are common, especially in male gender and
in patients coinfected with HDV. As HBV/HDV liver disease is generally more
rapidly progressive than that caused by HBV monoinfection, we speculate
that iron overload may be one of the factors contributing to the severity
of liver disease.

StephenW

J病毒Hepat。 2012年2月19（2）：E170 - 6。 DOI：
10.1111/j.1365-2893.2011.01508.x。 EPUB 2011 09月14日。肝脏铁超负荷
是常见的慢性乙型肝炎和更严重的是在患者合并感染
丁型肝炎病毒。资料来源：http://www.ncbi.nlm.nih.gov/pubmed/22239515
Sebastiani摹，Tempesta研发，阿尔贝蒂答SourceDigestive疾病，肝胆病
和临床营养学系，Dell'Angelo医院，威尼斯，意大利
组织学，微生物学和医学生物技术系，
帕多瓦大学，意大利帕多瓦。摘要摘要。肝脏铁
超载已影响辅酶慢性丙型肝炎
纤维化的进展。在慢性乙型肝炎患者的数据
是稀缺的。我们调查的肝铁矿床和血清铁指数
205 B型肝炎和代偿期肝病患者。
病人的平均年龄为42.4 ± 12.4岁，72.5％为男性。
合并感染丁型肝炎病毒（HDV）是目前的8.8％。至少
血清铁指数升高在41.5％的情况下。肝脏铁
存款中检出35.1％的患者，其中大多数是被最小
（I级）（59.7％）或轻度（II级）（27.8％）。变数显著
男性性别（P = 0.001），血清与肝铁矿床
铁蛋白（P = 0.008），GT（P = 0.05）和碱性磷酸酶（P = 0.05）
水平。通过多因素分析肝铁相关存款
血清铁蛋白[比值比（OR）的1.2，95％可信区间（CI）1.05-1.4，
P = 0.002]。存在的轻，中度（等级II和III）肝脏铁
存款可以排除与高阴性预测值（90％）
血清铁蛋白在正常价值。之间有显着相关性
还发现合并感染HDV和肝铁矿床（OR 4.23，95％
CI 1.52-11.82，P = 0.003）。当monoinfected案件相比，HDV
阳性的患者有更高的GT（P = 0.03），更先进的肝纤维化
更严重的铁矿床（P <0.0001）。总之，在
补偿的慢性乙肝病毒感染，肝铁矿床，
海拔血清铁指标是常见的，尤其是在男性的性别和
在患者合并感染与HDV。由于HBV / HDV肝脏疾病一般比较
比由乙肝病毒monoinfection引起的迅速进步，我们推测
，铁超负荷可能造成的严重性的因素之一
肝脏疾病