Chronic hepatitis c and hereditary hemochromatosis: A case report

Introduction. Between 20 - 60% of patients with chronic hepatitis C present with elevated serum ferritin and iron, as well as increased transferrin saturation, yet without a significant liver iron burden. The objective of this article was to summarize current knowledge on interactions between hepatitis C virus infection and iron metabolism. Case Report. A 34-year-old female patient positive for hepatitis C virus genotype 3, underwent therapy of chronic hepatitis C with pegylated interferon/ribavirin. The therapy was discontinued after four weeks due to leukopenia, anemia and significantly increased ferritin levels. Liver biopsy (Perl?s stain) revealed iron deposition predominantly in periportal hepatocytes. The therapy of chronic hepatitis C was continued by direct-acting (sofosbuvir/antiviral/velpatasvir) drugs. During the course of the therapy, the patient presented with normal complete blood count, ferritin of 150 ?g/l, and ferremia at upper limit of normal. Twelve weeks after the end of the therapy, the patient showed a sustained virologic response. The additional diagnostics of hereditary hemochromatosis has been performed, and therapeutic phlebotomy procedures were initiated. Conclusion. In patients with chronic hepatitis C and significantly elevated serum ferritin and iron, the diagnosis should be extended to hereditary hemochromatosis.