| 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
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