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 Table of Contents  
CORRESPONDENCE
Year : 2018  |  Volume : 131  |  Issue : 2  |  Page : 251

Iron Overload and Hepatitis C Virus Infection


1 Department of Medical Sciences, University of Turin, Torino 10126, Italy
2 Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena 53100, Italy

Date of Submission28-Sep-2017
Date of Web Publication08-Jan-2018

Correspondence Address:
Prof. Antonio Ponzetto
Department of Medical Sciences, University of Turin, Torino 10126
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0366-6999.222335

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How to cite this article:
Ponzetto A, Figura N. Iron Overload and Hepatitis C Virus Infection. Chin Med J 2018;131:251

How to cite this URL:
Ponzetto A, Figura N. Iron Overload and Hepatitis C Virus Infection. Chin Med J [serial online] 2018 [cited 2018 Apr 22];131:251. Available from: http://www.cmj.org/text.asp?2018/131/2/251/222335



To the Editor: We read with interest the review by Zou and Sun on the iron accumulation linked to hepatitis C virus (HCV) infection.[1] Whichever the mechanism for the overload, we would like to emphasize the important medical consequences of such accumulation; these encompass not only a worse prognosis of chronic hepatitis but also a higher risk of hepatocellular carcinoma (HCC),[1] Type 2 diabetes,[2] and heart failure/insufficiency.[3] All these complications are now epidemiologically demonstrated to occur in patients with chronic HCV infection, but they were well-established consequences of excessive iron storage; this, in turn, may be a consequence of several viral diseases, as reminded by Zou and Sun.[1] A very frequent complication of excessive iron deposits is infection by several bacterial species, including Helicobacter pylori. This pathogen is present worldwide, and found as coinfection in patients with liver cirrhosis and HCC; this association is highly frequent in China and Europe.[4],[5]H. pylori was shown to accelerate the progression toward cirrhosis and HCC, beyond its causative action in gastric cancer and peptic ulceration and bleeding. It is known the high risk of duodenal ulcer bleeding in cirrhotic patients; therefore, we suggest that the prudent physician should always test for the presence of H. pylori in all patients with chronic hepatitis, whether it is due to viral infections, iron overload, autoimmune diseases, or alcohol abuse.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Zou DM, Sun WL. Relationship between hepatitis C virus infection and iron overload. Chin Med J 2017;130:866-71. doi: 10.4103/0366-6999.202737.  Back to cited text no. 1
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2.
Simcox JA, McClain DA. Iron and diabetes risk. Cell Metab 2013;17:329-41. doi: 10.1016/j.cmet.2013.02.007.  Back to cited text no. 2
[PUBMED]    
3.
Gujja P, Rosing DR, Tripodi DJ, Shizukuda Y. Iron overload cardiomyopathy: Better understanding of an increasing disorder. J Am Coll Cardiol 2010;56:1001-12. doi: 10.1016/j.jacc.2010.03.083.  Back to cited text no. 3
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4.
Wang L, Zollinger T, Zhang J. Association between Helicobacter pylori infection and liver cancer mortality in 67 rural Chinese counties. Cancer Causes Control 2013;24:1331-7. doi: 10.1007/s10552-013-0211-3.  Back to cited text no. 4
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5.
Leone N, Pellicano R, Brunello F, Cutufia MA, Berrutti M, Fagoonee S, et al. Helicobacter pylori seroprevalence in patients with cirrhosis of the liver and hepatocellular carcinoma. Cancer Detect Prev 2003;27:494-7. doi: 10.1016/j.cdp.2003.07.004.  Back to cited text no. 5
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