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Comparative Study
. 2000 Feb;46(2):277-82.
doi: 10.1136/gut.46.2.277.

Liver iron is predictive of death in alcoholic cirrhosis: a multivariate study of 229 consecutive patients with alcoholic and/or hepatitis C virus cirrhosis: a prospective follow up study

N Ganne-Carrié  1 , C Christidis, C Chastang, M Ziol, F Chapel, F Imbert-Bismut, J C Trinchet, C Guettier, M Beaugrand
Affiliations
Comparative Study

Liver iron is predictive of death in alcoholic cirrhosis: a multivariate study of 229 consecutive patients with alcoholic and/or hepatitis C virus cirrhosis: a prospective follow up study

N Ganne-Carrié et al. Gut. 2000 Feb.

Abstract

Background/aims: A study was undertaken of liver biopsy samples from 229 consecutive patients with alcoholic or hepatitis C virus related cirrhosis who were prospectively followed until January 1996 to evaluate the influence of liver iron content on survival and the occurrence of hepatocellular carcinoma.

Methods: Hepatic iron content was measured with a validated semiquantitative score, and its predictive value for survival and the occurrence of hepatocellular carcinoma was assessed.

Results: 130 patients had detectable iron at enrollment. During follow up (57 (28) months), 95 patients died and 39 patients developed hepatocellular carcinoma. No significant relation was found between hepatic iron and the occurrence of hepatocellular carcinoma. Conversely, the presence of iron was predictive of death in alcoholic patients (p = 0.007) by the log rank test but not in patients with hepatitis C virus related (p = 0.71) or mixed (p = 0.98) cirrhosis. The predictive value of hepatic iron content in patients with alcoholic cirrhosis was confirmed by the Cox model using either a binary coding (p = 0.009; relative risk = 2.27; 95% confidence interval 1.2 to 4.19) or the continuous values (p = 0.002).

Conclusions: These results suggest that hepatic iron enhances liver lesions caused by alcohol but not those caused by hepatitis C virus.

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Figures

Figure 1
Figure 1
Occurrence of death according to the presence or the absence of stainable liver iron at enrolment in patients with alcoholic cirrhosis (Kaplan-Meier estimate). (A) Threshold of hepatic iron score = 1; (B) threshold of hepatic iron score = 5, corresponding to the median hepatic iron score of patients with stainable liver iron.
Figure 2
Figure 2
Occurrence of death according to the presence or absence of liver iron at enrolment in patients with HCV related cirrhosis with (A) and without (B) alcohol intake (Kaplan-Meier estimate).
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