الفهرس | Only 14 pages are availabe for public view |
Abstract For more than a decade, the relationship and comorbidity of iron overload and HCV infection among chronic hemodialysis patients has been an area of active clinical research. Although several studies have shown elevation of serum iron markers in hemodialysis patients with HCV, the clinical importance of this finding is debatable because there is not a conclusive association with disease severity. Hepatic iron content is usually only mildly elevated in chronic HCV infection, although elevated HIC is strongly predictive of response to interferon therapy and is associated with advanced disease. HFE mutations appear to cause acceleration of disease progression in HCV. Some, but not all, studies have shown a significant association between HFE genotype, HIC, and disease progression. It is likely that iron overload worsens liver disease in HCV through induction of oxidative stress and modification of cellular immunity. Iron depletion therapy clearly reduces serum aminotransferases, and may prove beneficial in delaying disease progression among patients who have not responded to interferon and ribavirin therapy. |