• J Formos Med Assoc · Jan 2025

    Long-term serum ferritin dynamics in patients receiving antiviral treatment for hepatitis C virus infection.

    • Yu-Ping Chang, Chiuan-Bo Huang, Jia-Horng Kao, Tung-Hung Su, Shang-Chin Huang, Tai-Chung Tseng, Pei-Jer Chen, Chun-Jen Liu, and Chen-Hua Liu.
    • Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
    • J Formos Med Assoc. 2025 Jan 22.

    BackgroundLimited data exists regarding the long-term serum ferritin dynamics following sustained virologic response (SVR12) and factors associated with trends in changes among patients undergoing treatment for hepatitis C virus (HCV).MethodsSerum ferritin levels were assessed biannually in 1538 participants undergoing direct-acting antivirals (DAAs) or peginterferon plus ribavirin (PR) with a median of follow-up of 5.0 years after off-treatment week 12. We compared the differences in time-dependent slope coefficients of serum ferritin levels for factors of interest using the generalized estimating equations to identify predictors associated with favorable serum ferritin evolution.ResultsUsing univariable analysis, SVR12, aged ≤50 year, absence of metabolic dysfunction-associated steatotic liver disease (MASLD), and pre-treatment HCV RNA level ≤2,000,000 IU/mL were associated with favorable ferritin evolution. Multivariable analysis showed that SVR12 (adjusted slope coefficient difference: 7.50 ng/mL/year [95% CI: 3.37 to -11.63], p < 0.001) and absence of MASLD (adjusted slope coefficient difference: 4.16 ng/mL/year [95% CI: 7.91 to -0.41], p = 0.022) predicted favorable ferritin evolution. Among participants achieving SVR12, the ferritin evolution was not affected by DAA or PR treatment (crude slope coefficient difference: 3.33 ng/mL/year [95% CI: 12.78 to 6.12], p = 0.49). Absence of MASLD was associated with favorable ferritin evolution (adjusted slope coefficient difference: 2.86 ng/mL/year [95% CI: 5.39 to -0.33], p = 0.021).ConclusionsPatients achieving SVR12, irrespective of types of treatment, exhibited more favorable long-term ferritin dynamics compared to those not achieving SVR12. Absence of MASLD may help improve long-term ferritin dynamics among patients achieving SVR12.Copyright © 2025 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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