Changes in serum iron levels due to infection with hepatitis B virus

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Abstract
A large number of patients with end-stage renal disease receiving renal dialysis were followed for 10 yr. Serum Fe and SGPT [serum-L-alanine 2-oxoglutarate aminotransferase, EC 2.6.1.2] levels in patients 1 mo. before infection, after infection but within the mo. of infection and 6-12 mo. after infection are described. Comparisons of serum Fe levels were made between those infected who retained the virus (carriers) and those who rejected the infection (transients). There were no differences between these groups before infection. Serum Fe remained high in the carrier group and dropped in the transients. Not all of the carriers retained high levels, although this was the case in general. Individual changes in the pre- and postconversion period were then considered. All carriers who had a preconversion decline in Fe had an increase after infection; this occurred in only some of the transients. Those carriers who had a decline after infection had raised levels before infection; the decline was generally less than the increase. Thus, elevation of Fe may be independent of rise in SGPT. Several hypotheses were derived from these findings. Individuals who are carriers in general have higher Fe levels and, therefore, are more likely to become infected with bacteria; this may contribute to increased morbidity and mortality. From experimental evidence, Fe is required for the growth of tumor cells. Carriers with elevated Fe levels may be more likely to develop detectable cancer of the liver than those who do not.