Objective:To study the correlation between serum iron markers and liver fibrosis in treatment-naive chronic hepatitis C urban patients.

Material and Methods:Fifty patientswith treatment-naïve chronic hepatitis C from database (E-phis) in the Liver Clinic from January to December 2017, aged between 18–80 years, were examined for serum iron markers, laboratory investigations and measurement of the liver stiffness.

Results: Eleven patients (22%) had normal serum aspartate aminotransferase (AST) and serum alanine aminotransferase (ALT) levels. Thirty-four patients (68%) had a normal serum iron level, and 31 (62%) had a normal ferritin level. The mean serum levels of iron (p=0.003, p < 0.001), ferritin (p=0.020, p=0.035) and transferrin saturation (p=0.007, p=0.015) showed significant positive correlations with AST and ALT. The mean levels of AST, ferritin, total iron binding capacity (TIBC) and transferrin saturation were significantly higher in patients of the significant fibrosis group than in the no/minimal fibrosis group (p = 0.013, 0.006, 0.049 and 0.030, respectively). Seventy-five percent of the patients with elevated serum ferritin had progressed to a stage of advanced fibrosis. In the hepatocellular carcinoma group, the mean ferritin was significantly higher than in the non-HCC group (p = 0.010).

Conclusion:Serum ferritin was normal in all treatments-naïve chronic hepatitis C with no-minimal fibrosis.  Even with a low sensitivity, a higher level may be useful to identify patients at risk of advanced fibrosis but not for necroinflammation. However, in extremely high levels of ferritin, medical professionals need to beware of the possibility of hepatocellular carcinoma.