Efficacy and safety of 6-month iron reduction therapy in patients with hepatitis C virus-related cirrhosis: a pilot study

Background Iron reduction therapy (IRT) has been recognized as beneficial for chronic hepatitis C patients. However, its efficacy for hepatitis C virus-related liver cirrhosis (LC-C) has not been elucidated. We evaluated the efficacy and safety of IRT for LC-C patients. Methods Twenty-two LC-C patients were treated with biweekly phlebotomy and low iron diet for 6 months, in addition to regular hepatoprotective therapy. Nineteen sex- and age-matched patients who refused to receive IRT were used as controls. The efficacy of IRT was evaluated on the basis of biochemical parameters. Results Of 22 patients receiving IRT, 19 completed the 6-month treatment. IRT significantly reduced serum levels of aspartate aminotransferase (from 89 to 57U/L; P = 0.003), alanine aminotransferase (from 101 to 54U/L; P < 0.001), and alpha-fetoprotein (from 28 to 12g/mL; P = 0.003). These changes were not observed in the controls. Two patients whose serum albumin concentrations were less than 3.6g/dL at the beginning of IRT withdrew from IRT because of the new appearance of ascites. Conclusions IRT improved the serum levels of aminotransferases and alpha-fetoprotein in LC-C patients and was generally safe; however, IRT should be performed in patients who maintain serum albumin concentrations of more than 3.6g/dL.