The use of deferoxamine infusions to enhance the response rate to interferon-α treatment of chronic viral hepatitis B |
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Authors: | Y Bayraktar T Koseoglu C Somner B Kayhan A Temizer B Uzunalimoglu N De Maria D H Van Thiel |
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Institution: | Gastroenterology Department;Pathology Department, Hacettepe University, School of Medicine, Ankara, Turkey;Analytic Chemistry Department, Hacettepe University, Faculty of Medicine, Ankara, Turkey;Alcohol and Liver Diseases Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA |
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Abstract: | Summary An individual's iron status may affect the response rate achieved with the use of interferon (IFN) as therapy for chronic viral hepatitis. A total of 27 patients with chronic hepatitis B viral infection, who had elevated serum ferritin levels, were randomized to receive either IFN 5 MU, three times weekly by subcutaneous injection alone ( n = 14) or in combination with cycles of deferoxamine at a dose of 80 mg kg-1 per cycle ( n = 13) administered over 3 consecutive days, to reduce their iron and maintain a serum ferritin level less than 250 ng ml-1. All deferoxamine-treated patients were on a low iron-containing diet. An IFN response was defined as a normalization of the serum alanine aminotransferase (ALT) level and seroconversion from hepatitis B e antigen (HBeAg) positivity to hepatitis B e antibody (HBeAb) positivity. The deferoxamine-treated group experienced a reduction in their serum ferritin level to 226 ± 73 ng ml-1 as a result of the deferoxamine treatment. Six of the 13 (46%) deferoxamine-treated patients and two of the 14 (14%) control patients normalized their ALT levels. Seven of the 13 (54%) deferoxamine but only 14% of the IFN-treated group seroconverted to HBeAb positivity. A greater rate of histological improvement and loss of hepatitis B virus (HBV) DNA was seen in the deferoxamine-treated group. Two of the deferoxamine-treated patients were treated only once, two were treated twice, seven were treated three times and two were treated four times to achieve a ferritin level below 250 ng ml-1. |
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Keywords: | antiviral therapy ferritin iron liver seroconversion |
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