肝铁超负荷在慢性乙型肝炎中常见，而在丁型肝炎病毒双重

StephenW

                          肝铁超负荷在慢性乙型肝炎中常见，而在丁型肝炎病毒双重感染的患者中更为严重
                          Hepatic iron overload is common in chronic hepatitis B and is more severe in patients coinfected with hepatitis D virus                    

                           来自:J VIRAL HEPATITIS(2012-02-01)

                              

              作者：                               G. Sebastiani, D. Tempesta, A. Alberti                           
                PMID：                                                           暂无                                                                          

                   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

肝铁超载是常见的慢性B型肝炎和丁型肝炎病毒合并感染的患者更严重

来自：J病毒性肝炎（2012年2月1日）
A. D. Tempesta，G. Sebastiani，阿尔贝蒂
关键词：暂无
慢性丙型肝炎肝铁超载已被描述辅作为影响纤维化的进展。慢性乙型肝炎患者中的数据是稀缺的。我们调查的205例乙型肝炎和代偿性肝脏疾病的肝铁矿床和血清铁指标。的患者平均年龄为42.4±12.4岁，72.5％为男性。合并感染丁型肝炎病毒（HDV）是目前在8.8％。在41.5％的病例至少一个血清铁指数升高。在35.1％的患者，其中大多数是最小检测肝铁矿床（I级）（59.7％）或轻度（II级）（27.8％）。肝铁矿床的显着相关的变量为男性性别（P = 0.001），血清铁蛋白（P = 0.008），伽玛] GT（p = 0.05）和碱性磷酸酶（p = 0.05）的水平。由多元相关分析肝铁，血清铁蛋白[比值比（OR）1.2，95％可信区间（CI）1.05-1.4，磷= 0.002]。存款轻，中度（等级II和III）肝铁矿床的存在可以排除与高阴性预测值（90％）时，血清铁蛋白正常值内。还发现一个显着相关性之间的合并感染HDV和肝铁矿床（OR 4.23，95％CI为1.52-11.82，P = 0.003）。相比monoinfected案件时，HDV的阳性患者有更多的升高[γ] GT（p = 0.03），更先进的肝纤维化和更严重的铁矿床（P <0.000）。总之，在补偿的慢性丙型肝炎感染，肝铁矿床和血清铁指标的海拔是常见的，尤其是男性，并在与HDV同时感染的患者。由于乙肝/ HDV肝病的一般比较迅速比乙肝monoinfection引起的进步，我们推测，铁超载可能是导致肝脏疾病的严重程度的因素之一。