Bomfim Ednaldo Andrade, Pereirade de Oliveira Andrea Cristina, Paraná Raymundo, Schinoni María Isabel
Escuela de Medicina, Universidad Federal de Bahia (UFBa), Bahia, Brasil.
Acta Gastroenterol Latinoam. 2013 Sep;43(3):212-7.
Hepatitis C is a worldwide chronic liver disease. Different factors have been found to be associated with an increased progression to severe liver fibrosis, such as alcohol intake higher than 30 g/day, older age at infection and co-infection. Nevertheless, different research centers have found conflicting data concerning the liver iron overload fibrogenic role.
To assess the association between hepatic iron overload and fibrosis stage grades in hepatitis C Virus carriers, hepatic steatosis and demographic variables.
In this descriptive study we recruited 290 positive anti-HCV and qualitative HCV-RNA, treatment naive chronic hepatitis C outpatients registered fom 2007 to 2009 at the Federal University of Bahia's Hospital. The variables studied in the liver biopsy results were: 1) fibrosis stage according to META VIR score (F0-F4), 2) iron overload presence or absence according to Perls staining, and 3) presence or absence of steatosis. Fibrosis stages were categorized as mild/moderate (F0-F2) and severe (F3-F4). Exclusion criteria were hepatitis B virus and human immunodeficiency virus co-infection, and primary or secondary hemochromatosis. The statistical analysis was performed using Chi-square and Student's t tests, with the ssoftware: SPSS 17. A P value < 0.05 was considered as significant.
Severe fibrosis was statistically associated with older age, iron overload presence (P = 0.003) and steatosis (P = 0.01).
In this study hepatic iron overload and hepatic steatosis were associated with severe hepatic fibrosis (METAVIR F3-F4).
丙型肝炎是一种全球性的慢性肝病。已发现不同因素与严重肝纤维化进展增加有关,如每日酒精摄入量高于30克、感染时年龄较大以及合并感染。然而,不同研究中心关于肝脏铁过载的促纤维化作用的数据相互矛盾。
评估丙型肝炎病毒携带者的肝脏铁过载与纤维化阶段分级、肝脂肪变性及人口统计学变量之间的关联。
在这项描述性研究中,我们招募了290名抗-HCV阳性且HCV-RNA定性、未经治疗的慢性丙型肝炎门诊患者,这些患者于2007年至2009年在巴伊亚联邦大学医院登记。在肝活检结果中研究的变量包括:1)根据METAVIR评分的纤维化阶段(F0-F4),2)根据派尔司染色确定铁过载的有无,3)脂肪变性的有无。纤维化阶段分为轻度/中度(F0-F2)和重度(F3-F4)。排除标准为乙型肝炎病毒和人类免疫缺陷病毒合并感染以及原发性或继发性血色素沉着症。使用卡方检验和学生t检验进行统计分析,软件为SPSS 17。P值<0.05被认为具有统计学意义。
重度纤维化与年龄较大、存在铁过载(P = 0.003)和脂肪变性(P = 0.01)在统计学上相关。
在本研究中,肝脏铁过载和肝脂肪变性与严重肝纤维化(METAVIR F3-F4)相关。