Gender and liver fibrosis in chronic hepatitis: the role of iron status

Background: The role of gender in the progression of fibrosis in chronic hepatitis C is still under investigation. Aim: To investigate whether gender affects the progression of liver disease and/or hides other risk factors. Methods: A prospective series of 121 consecutive patients with chronic hepatitis C underwent liver biopsy. Grading and staging for chronic hepatitis were each evaluated according to Ishak's classification. Results: In univariate and multivariate analysis on the whole group of patients, male gender was not associated either with significant liver fibrosis (Ishak's score >2) or with cirrhosis (Ishak's score >4). On the contrary, in univariate analysis on patients aged ≤50 years, male gender was nearly significantly (P = 0.06) predictive of liver fibrosis, whereas it was not in patients >50 years. Hepatic iron grading, along with age, was an independent factor associated with fibrosis. Moreover, the values of all the variables which describe iron status were significantly higher in males aged ≤50 years in comparison with females of the same age. Conclusions: In chronic hepatitis C, male gender may be predictive of liver fibrosis only in patients aged ≤50 years. Among fibrogenetic factors hidden by gender, iron status could play a major role.