TY - JOUR
T1 - Liver Diseases in the Hemochromatosis and Iron Overload Screening Study
AU - Adams, Paul C.
AU - Passmore, Leah
AU - Chakrabarti, Subrata
AU - Reboussin, David M.
AU - Acton, Ronald T.
AU - Barton, James C.
AU - McLaren, Gordon D.
AU - Eckfeldt, John H.
AU - Dawkins, Fitzroy W.
AU - Gordeuk, Victor R.
AU - Harris, Emily L.
AU - Leiendecker-Foster, Catherine
AU - Gossman, Elaine
AU - Sholinsky, Phyliss
PY - 2006/7
Y1 - 2006/7
N2 - Background & Aims: The Hemochromatosis and Iron Overload Screening (HEIRS) Study screened 101,168 primary care participants for iron overload with serum transferrin saturation (TS), ferritin, and C282Y and H63D mutations of the HFE gene. Methods: All C282Y homozygotes and participants with an increased TS (>45% women, >50% men) and serum ferritin level (> 200 μg/L women, >300 μg/L men) were recalled for a clinical history and physical examination, and blood tests including alanine transaminase (ALT) and aspartate transaminase levels. Hepatitis B surface antigen and anti-hepatitis C virus were measured if the ALT level was increased (>31 IU/L in women, >40 IU/L in men). Results: In the group of participants selected to return for clinical examination because of increased TS and ferritin levels, ALT increases and anti-hepatitis C virus were found in 95 of 284 (33%) African Americans, 50 of 466 (11%) Asian and Pacific Islanders, 21 of 120 (18%) Hispanics, and 40 of 477 (8.4%) Caucasians. ALT increases and hepatitis B surface antigen were detected in 24 of 466 (5%) Asian and Pacific Islanders, 10 of 284 (3.5%) African Americans, 3 of 120 (2.5%) Hispanics, and 2 of 477 (.42%) Caucasians. Of 86 liver biopsy specimens obtained for clinical purposes, 53 were reviewed by a single study pathologist. Liver fibrosis (stage 3 or 4) was present in 2 of 11 (18.2%) C282Y homozygotes that underwent central review and 2 of 302 (.66%) C282Y homozygotes attending the clinical examination. Conclusions: Screening for iron overload with ferritin and TS detects persons with viral hepatitis and other types of liver disease. A minimum of .66% C282Y homozygotes have liver fibrosis.
AB - Background & Aims: The Hemochromatosis and Iron Overload Screening (HEIRS) Study screened 101,168 primary care participants for iron overload with serum transferrin saturation (TS), ferritin, and C282Y and H63D mutations of the HFE gene. Methods: All C282Y homozygotes and participants with an increased TS (>45% women, >50% men) and serum ferritin level (> 200 μg/L women, >300 μg/L men) were recalled for a clinical history and physical examination, and blood tests including alanine transaminase (ALT) and aspartate transaminase levels. Hepatitis B surface antigen and anti-hepatitis C virus were measured if the ALT level was increased (>31 IU/L in women, >40 IU/L in men). Results: In the group of participants selected to return for clinical examination because of increased TS and ferritin levels, ALT increases and anti-hepatitis C virus were found in 95 of 284 (33%) African Americans, 50 of 466 (11%) Asian and Pacific Islanders, 21 of 120 (18%) Hispanics, and 40 of 477 (8.4%) Caucasians. ALT increases and hepatitis B surface antigen were detected in 24 of 466 (5%) Asian and Pacific Islanders, 10 of 284 (3.5%) African Americans, 3 of 120 (2.5%) Hispanics, and 2 of 477 (.42%) Caucasians. Of 86 liver biopsy specimens obtained for clinical purposes, 53 were reviewed by a single study pathologist. Liver fibrosis (stage 3 or 4) was present in 2 of 11 (18.2%) C282Y homozygotes that underwent central review and 2 of 302 (.66%) C282Y homozygotes attending the clinical examination. Conclusions: Screening for iron overload with ferritin and TS detects persons with viral hepatitis and other types of liver disease. A minimum of .66% C282Y homozygotes have liver fibrosis.
UR - http://www.scopus.com/inward/record.url?scp=33744921460&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33744921460&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2006.04.013
DO - 10.1016/j.cgh.2006.04.013
M3 - Article
C2 - 16797244
AN - SCOPUS:33744921460
SN - 1542-3565
VL - 4
SP - 918-923,923.e1
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 7
ER -