Hepatitis C and IronOver 4 million Americans have been infected
with the hepatitis C virus (HCV). Hep C infects the liver and is
responsible for 10,000 - 12,000 deaths each year.
The liver is the critical organ in the body for the metabolism of iron. Excess iron in the body can be very damaging.
Patients
with chronic hepatitis C often have an increase of iron concentration
in the liver. Iron load may have a serious effect on HCV infection, and
in turn, the HCV may alter regulation of iron homeostasis.
Many
studies about the relationship between iron and HCV are inconclusive
because there are so many factors to rule out — such as race, gender,
age and stage of the disease, and the genetic mutation of the HFE gene
present in hemochromatosia — all of which profoundly affect results.
It
is also challenging to determine whether the increased iron levels seen
in individuals with cirrhotic HCV facilitate progression toward
end-stage liver disease or are a result of increased iron in the
cirrhotic liver.
But almost all studies suggest that iron
overload is associated with more advanced HCV disease, poor response to
interferon monotherapy, and increased risk of liver cancer. In some
studies, increased iron has actually been shown to enhance the growth of
the hepatitis C virus in the laboratory. There is also general
agreement about the likelihood that iron overload worsens liver disease
in HCV through oxidative stress and affecting cellular immunity. It has
also been found that it is not just the amount of iron in the liver that
is important, but also the distribution of the iron within an
HCV-infected liver.
Liverdisease.com, suggests, that people with
chronic HCV whose serum iron level is elevated, or who have cirrhosis,
should probably avoid taking iron supplements. In addition, it suggests
they should restrict their intake of iron-rich foods, such as red meats,
liver, and iron-fortified cereals, and should avoid cooking with
iron-coated cookware and utensils. Iron depletion therapy may be
indicated to delay disease progression.
As scientific and medical
studies continue to explore the relationship between iron and HCV, new
recommendations are likely to surface.
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