Serum ferritin levels are associated with a distinct phenotype of chronic hepatitis C poorly responding to pegylated interferon-α and ribavirin therapy

Hepatology. 2011 Nov 16. doi: 10.1002/hep.24787. [Epub ahead of print]

Lange CM, Kutalik Z, Morikawa K, Bibert S, Cerny A, Dollenmaier G, Dufour JF, Gerlach TJ, Heim MH, Malinverni R, Müllhaupt B, Negro F, Moradpour D, Bochud PY; the Swiss Hepatitis C Cohort Study Group.

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Division of Gastroenterology and Hepatology, University Hospital Lausanne, CH-1011 Lausanne, Switzerland; Medizinische Klinik 1, Klinikum der J. W. Goethe-Universität Frankfurt a.M., D-60590 Frankfurt a.M., Germany. Christian.Lange@chuv.ch.

Abstract

Elevated serum ferritin levels may reflect a systemic inflammatory state as well as increased iron storage, both of which may contribute to an unfavorable outcome of chronic hepatitis C. We therefore performed a comprehensive analysis of the role of serum ferritin and their genetic determinants in the pathogenesis and treatment of chronic hepatitis C. To this end, serum ferritin levels at baseline of therapy with pegylated interferon-α and ribavirin or before biopsy were correlated with clinical and histological features of chronic HCV infection, including necroinflammatory activity (N=970), fibrosis (N=980), steatosis (N=886) and response to treatment (N=876). The association between high serum ferritin levels (>median) and the endpoints was assessed by logistic regression. Moreover, a candidate gene as well as a genome-wide association study of serum ferritin were performed. We found that serum ferritin ≥ the sex-specific median was one of the strongest pre-treatment predictors of treatment failure (univariate P<0.0001, OR=0.45, 95% CI=0.34-0.60). This association remained highly significant in a multivariate analysis (P=0.0002, OR=0.35, 95% CI=0.20-0.61), with an odds ratio comparable to that of IL28B genotype. When patients with the unfavorable IL28B genotypes were stratified according to high vs. low ferritin levels, SVR rates differed by >30% in both HCV genotype 1- and 3-infected patients (P<0.001). Serum ferritin levels were also independently associated with severe liver fibrosis (P<0.0001, OR=2.67, 95% CI=1.68-4.25) and steatosis (P=0.002, OR=2.29, 95% CI=1.35-3.91) but not with necroinflammatory activity (P=0.3). Genetic variations had only a limited impact on serum ferritin levels. CONCLUSION: In patients with chronic hepatitis C, elevated serum ferritin levels are independently associated with advanced liver fibrosis, hepatic steatosis, and poor response to interferon-α-based therapy. (HEPATOLOGY 2011.).

Copyright © 2011 American Association for the Study of Liver Diseases.

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AHF Launches Campaign Against AIDS Discrimination at Hershey School

Dec. 15, 2011, 4:02 p.m. EST

At Washington D.C. press conference scheduled for Friday, December 16th at 10:00 AM Eastern, AIDS Healthcare Foundation (AHF) will announce willingness to contribute up to $50,000 to support federal discrimination lawsuit filed by AIDS Law Project of Pennsylvania against the school on behalf of the 13-year-old boy and his mother

WASHINGTON, Dec 15, 2011 (BUSINESS WIRE) -- AIDS Healthcare Foundation (AHF) will host an in-person press conference and teleconference on Friday, December 16, 2011 at 10:00 am at the National Press Club (529 14th Street NW, 13th Floor) to announce the launch of a campaign against HIV/AIDS discrimination at Hershey School in Pennsylvania and in support of the federal discrimination lawsuit filed on behalf of a 13-year-old boy who was rejected for admission at Hershey explicitly due to his HIV-positive status. At the event, AHF will announce its willingness to contribute up to $50,000 to support the lawsuit filed by AIDS Law Project of Pennsylvania and will express its moral outrage at the case, which first made news earlier this month, on December 1, 2011 -- World AIDS Day.

According to the Associated Press (claim:Hershey School Rejects HIV-Positive Pa. Boy)(claim:By Peter Jackson)(claim:12/1/11): "A private boarding school connected with the Hershey chocolate company says it was trying to protect other students when it denied admission to a Philadelphia-area teenager because he is HIV-positive. The AIDS Law Project of Pennsylvania filed a lawsuit on behalf of the unidentified boy in U.S. District Court in Philadelphia on Wednesday, claiming the Milton Hershey School for disadvantaged students violated the Americans with Disabilities Act. School officials acknowledged that the 13-year-old boy was denied admission because of his medical condition. They said they believed it was necessary to protect the health and safety of the 1,850 others enrolled in the residential institution, which serves children in pre-kindergarten to 12th grade and where students live in homes with 10 to 12 others."

WHAT: Press Conference & Teleconference - Hershey School Rejection of HIV+ Boy

WHEN: Friday, December 16th - 10:00 am, Eastern

WHERE: National Press Club
529 14th Street NW, 13th
Floor Washington D.C. 20045

HOW: Dial in: 1-877-411 9748 Access Code: 7931503

WHO: Michael Weinstein, President, AIDS Healthcare Foundation Tom Myers, Chief of Public Affairs & General Counsel, AIDS Healthcare Foundation

AHF CONTACTS: Ged Kenslea : (323) 791-5526 mobile; Lori Yeghiayan: (323) 377-4312 mobile

"We are morally outraged by the blatant discrimination shown by the Hershey School in this case. As the largest global AIDS organization, we did not feel like AHF could stand by without offering support to AIDS Law Project of the Pennsylvania and the suit they have filed on behalf of the student," said Michael Weinstein, President of AIDS Healthcare Foundation. "The ignorance displayed by the Hershey School's leadership is unacceptable and demonstrates just how much work there is still to be done to dismantle the fear and misinformation that still surrounds this disease more than 25 years after Ryan White."

Ryan White was an American teenager from Kokomo, Indiana who, in the mid-1980s, was expelled from middle school because he was HIV-positive. A lengthy legal battle with the school ensued and White became a galvanizing force in educating the country about HIV & AIDS at a time when misinformation about the disease was widespread. After his death in 1990, the U.S. Congress passed a major piece of legislation named in his honor, the Ryan White CARE Act, which provides funding for HIV/AIDS programs for low-income Americans.

About AIDS Healthcare Foundation

AIDS Healthcare Foundation (AHF), the largest global AIDS organization, currently provides medical care and/or services to more than 123,000 individuals in 26 countries worldwide in the US, Africa, Latin America/Caribbean, the Asia/Pacific Region and Eastern Europe. www.aidshealth.org 

SOURCE: AIDS Healthcare Foundation

        AHF

        Ged Kenslea


        Communications Director


        Cell: (323) 791-5526


        gedk@aidshealth.org 
        Lori Yeghiayan


        Assoc. Dir. of Communications


        Office: (323) 308-1834 Cell: (323) 377-4312

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Clinical Care Options Launches CCO Hepatology inPractice™, Adding a Third Specialty to its Comprehensive Online Resource

RESTON, Va., Dec. 15, 2011 /PRNewswire/ -- Clinical Care Options (CCO), a leader in the development of innovative online, print, and live medical education programs and medical education technologies for healthcare professionals, is proud to announce the launch of CCO Hepatology inPractice™, the third specialty area for the free, online point-of-care resource for clinicians that provides critical information for the management of viral hepatitis. CCO HIV inPractice™ and CCO Oncology inPractice™, now used around the world, are available at inPractice.com.

CCO Hepatology inPractice™, authored by 14 world-renowned experts and led by Editors in Chief Nezam H. Afdhal, MD, FRCPI, of Harvard University; Norah Terrault, MD, MPH, of the University of California, San Francisco; and Stefan Zeuzem, MD, of JW Goethe University Hospital, provides a single easy-to-use search interface. Performing a search on Hepatology inPractice initially allows the busy clinician direct access to the first 10 original, expert-authored chapters designed specifically for point-of-care use, integrated with drug information, treatment guidelines, conference coverage, PubMed abstracts, and ClinicalTrials.gov.

"In the fast-changing field of viral hepatitis, this innovative point-of-care resource combining regularly updated content and the ability to simultaneously search multiple key reference sources is an essential tool to enable clinicians to provide the very best patient care," commented Dr. Terrault. Drs. Afdhal, Terrault, and Zeuzem will continue to oversee regular updates to this dynamic program ensuring that the original textbook chapters remain current as best practices in hepatitis care are updated.

"We are delighted to release CCO Hepatology inPractice™ to our users today. Our HIV and Oncology inPractice™ resources have been used by more than 50,000 clinicians needing access to the latest and highest-quality management information over the course of the last 2 years," said Jeffrey L. Drezner, MD, PhD, CCO's Chief Executive Officer and Founder. "The addition of Hepatology inPractice™ underscores our ongoing commitment to improving patient care across the spectrum of healthcare."

CCO Hepatology inPractice™ is certified for point-of-care CME credit by USF Health and users will be able to earn point-of-care CME for searching this comprehensive reference. All CCO inPractice™ users also receive personalized recommendations for complementary CCO continuing education activities and access links to other resources and interactive tools. The program is supported by independent medical education grants provided by multiple commercial supporters.

For more information about CCO inPractice™, visit inPractice.com.

About Clinical Care Options
Clinical Care Options, a leader in the development of innovative, interactive, online medical education programs and proprietary medical education technologies for healthcare professionals, creates and publishes original continuing medical education and information resources that are designed specifically for healthcare providers in the areas of HIV, hepatology/gastroenterology, and oncology. CCO's educational programs are developed not only to provide the latest scientific information but also to support the understanding, confidence, application, and competence of healthcare professional learners. In addition to the latest point-of-care resource, inPractice, CCO provides a spectrum of live and online educational programs and formats. For more information about the company and its programs, visit clinicaloptions.com.

SOURCE Clinical Care Options

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