Di Bisceglie AM, et al. Iron Reduction as an
Adjuvant to Interferon Therapy in Patients With Chronic
Hepatitis C Who Have Previously Not Responded to Interferon:
A Multicenter, Prospective, Randomized,
Controlled Trial. Hepatology 2000 Jul;32(1):135-138
Hepatic iron concentration has consistently been observed
as being directly correlated with the response to interferon
therapy in chronic hepatitis C virus (HCV). We
therefore conducted a randomized, controlled trial comparing
iron reduction by phlebotomy with iron reduction followed
by retreatment with interferon in 96 patients with chronic
hepatitis C who had previously not responded to a course
of interferon. During the initial phase when all
patients were undergoing phlebotomy, we found that serum
alanine transaminase (ALT) activities decreased
but by less than 50% from baseline in 67 patients (89%),
decreased by more than 50% in 12 patients (13%)
and became normal in 9 patients (9%) with no
overall change in HCV-RNA levels.
Subsequently no patient in either treatment group achieved
a sustained virologic response. Improvements in
necroinflammatory changes were noted in liver biopsy specimens
in those patients receiving phlebotomy plus interferon
(mean index 8.59 vs. 7.37, P <.05). A
slight but not statistically significant decrease in histologic
activity index was noted in those subjects treated by
phlebotomy alone (mean index 8.4 vs. 7.75, P not significant).
We conclude that, although prior phlebotomy therapy does
not improve the rate of sustained response to interferon
retreatment, it does result in less liver injury manifested
by a decrease in serum transaminase activity and a slight
improvement in liver histopathology.
Comment: Phlebotomy
generally involves drawing one pint of blood at a time
to reduce red blood cells and blood iron.This study showed
that this procedure decreased damage to liver cells.
I have been telling people and doctors this for years!
It makes a big difference in 25% of men and post menopausal
women. It makes a difference even if there is not a obvious
iron over load.
Doctors will not perform this procedure. The reason is
because most physician's malpractice insurance does not
cover Phlebotomy. Chelation doctors malpractice insurance
does and so they are the people to see for this much needed
therapy.
In good health
Lloyd
