Hepatitis C and Iron

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Over 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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