Prevalence and characteristics of anti-HCV positivity and chronic hepatitis C virus infection in HFE p.C282Y homozygotes

• Main Authors: James C. Barton, J. Clayborn Barton, Paul C. Adams
• Format: Article
• Language: English
• Published: Elsevier 2019-03-01
• Series: Annals of Hepatology
• Subjects: Alanine aminotransferase; Anti-HCV antibody; Chronic hepatitis C; Hemochromatosis; Serum ferritin
• Online Access: http://www.sciencedirect.com/science/article/pii/S1665268119300158

Introduction and aim: Observations of hepatitis C virus (HCV) infection in adults with hemochromatosis are limited. Materials and methods: We determined associations of serum ferritin (SF) with anti-HCV in non-Hispanic white North American adults in a post-screening examination. Cases included p.C282Y homozygotes (regardless of screening transferrin saturation (TS) and SF) and participants (regardless of HFE genotype) with high screening TS/SF. Controls included participants without p.C282Y or p.H63D who had normal screening TS/SF. Participants with elevated alanine aminotransferase underwent anti-HCV testing. We determined prevalence of chronic HCV infection in consecutive Alabama and Ontario referred adults with HFE p.C282Y homozygosity. Results: In post-screening participants, anti-HCV prevalence was 0.3% [95% CI: 0.02, 2.2] in 294 p.C282Y homozygotes, 9.5% [7.2, 12.3] in 560 Cases without p.C282Y homozygosity, and 0.7% [0.2, 2.3] in 403 Controls. Anti-HCV was detected in 7.2% of 745 participants with and 0.8% of 512 participants without elevated SF (odds ratio 9.9 [3.6, 27.6]; p < 0.0001). Chronic HCV infection prevalence in 961 referred patients was 1.0% (10/961) [95% confidence interval (CI): 0.5, 2.0]. Ten patients with chronic HCV infection had median age 45 y (range 29–67) and median SF 1163 μg/L (range 303–2001). Five of eight (62.5%) patients had biopsy-proven cirrhosis. Conclusions: Odds ratio of anti-HCV was increased in post-screening participants with elevated SF. Prevalence of anti-HCV in post-screening participants with HFE p.C282Y homozygosity and chronic HCV infection in referred adults with HFE p.C282Y homozygosity in North America is similar to that of Control participants with HFE wt/wt and normal screening TS/SF.