Is Serum Ferritin a Suitable Predictor of Treatment Outcomes in Chronic Hepatitis C Patients Treated with Interferon–Ribavirin Combined Therapy?

Introduction: This study was designed to find out if serum ferritin can be used as a predictor of treatment outcomes in chronic hepatitis C patients treated with interferon–ribavirin combination therapy. Patients and Methods: The study included 15 chronic hepatitis C patients treated with pegylated interferon and ribavirin with sustained virological response and nine patients ending treatment without sustained virological response. Laboratory investigations of liver functions, kidney functions, complete blood picture, fasting blood glucose, hepatitis B surface antigen, alpha fetoprotein, pregnancy test, ANA and Thyroid-stimulating hormone were carried out for these patients. Serum hepatitis C Virus (HCV)-RNA was measured after starting the antiviral therapy and 24 weeks later. The levels of serum ferritin were measured by ELISA in sera of all patients. Results: Before treatment serum ferritin levels were higher in group 2 patients. The pre- and on- treatment serum ferritin levels were positively linked with body weight and hepatic iron score. Upon treatment, serum ferritin levels increased in group 1 more than group 2 patients. Post-treatment, serum ferritin levels were lower in group 1 than those in group 2 patients. Serum ferritin levels from this period were associated only with hepatic fibrosis score on pre-treatment liver biopsy. During the 5th month post-treatment a further decline in serum ferritin levels occurred and serum ferritin levels returned towards baseline (pre-treatment) values. The degree of decline during this period was slightly higher in group 2 than in group 1. Conclusions: Measurement of serum ferritin level has a role in prediction of sustained virological response in chronic HCV patients during treatment with antiviral agents. This role might help in monitoring HCV patients’ response to treatment.