medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-142medsovet-7566Research ArticleЗАБОЛЕВАНИЯ БИЛИАРНОЙ СИСТЕМЫ И ПЕЧЕНИDISEASES OF THE BILIARY SYSTEM AND LIVERГиперферритинемия, хронический гепатит С и COVID-19: что общего?Hyperferritinemia, chronic hepatitis C and COVID-19: what do they have in common?https://orcid.org/0000-0002-0605-8057ГоникМ. И.GonikM. I.

Гоник Максим Игоревич, врач-гастроэнтеролог 

117997, Москва, ул. Профсоюзная, д. 86

Maxim I. Gonik, Gastroenterologist 

86, Profsoyuznaya St., Moscow, 117997

maxim.gonik@yandex.ruhttps://orcid.org/0000-0002-0700-9775БуевероваЕ. Л.BueverovaE. L.

Буеверова Елена Леонидовна, к.м.н., доцент кафедры пропедевтики внутренних болезней, гастроэнтерологии и гепатологии 

119435, Москва, ул. Погодинская, д.1, стр. 1

Elena L. Bueverova, Cand. Sci. (Med.), Associate Professor, Department of Internal Disease Propaedeutics, Gastroenterology and Hepatology 

1, Bldg. 1, Pogodinskaya St., Moscow, 119991

bueverova_e_l@staff.sechenov.ruhttps://orcid.org/0000-0002-5041-3466БуеверовА. О.BueverovA. O.

Буеверов Алексей Олегович, д.м.н., профессор кафедры медико-социальной экспертизы, неотложной и патогенетической терапии; ведущий научный сотрудник отделения гепатологии 

119048, Москва, ул. Трубецкая, д. 8, стр. 2;129110, Москва, ул. Щепкина, д. 61/2

Aleksey O. Bueverov, Dr. Sci. (Med.), Professor, Chair of Medical and Social Expertise, Emergency and Pathogenetic Therapy; Leading Researcher, Department of Hepatology 

8, Bldg. 2, Trubetskaya St., Moscow, 119991;61/2, Bldg. 1, Schepkin St., Moscow, 129110

bcl72@yandex.ruРоссийский научный центр рентгенорадиологииРоссияRussian Scientific Center of RoentgenoradiologyRussian FederationИнститут клинической медицины имени Н.В. Склифосовского Первого Московского государственного университета имени И.М. Сеченова (Сеченовский Университет)РоссияSklifosovskiy Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University)Russian FederationИнститут профессионального образования Первого Московского государственного университета имени И.М. Сеченова (Сеченовский Университет); Московский областной научно-исследовательский клинический институт имени М.Ф. ВладимирскогоРоссияInstitute of Professional Education, Sechenov First Moscow State Medical University (Sechenov University); Moscow Regional Research Clinical Institute named after M.F. VladimirskyRussian Federation20232505202308150157Copyright © Гоник М.И., Буеверова Е.Л., Буеверов А.О., 20232023Гоник М.И., Буеверова Е.Л., Буеверов А.О.Gonik M.I., Bueverova E.L., Bueverov A.O.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7566

Ферритин является одним из ключевых белков, который участвует в регуляции гомеостаза уровня железа в организме. Его сниженные значения часто связывают с изменением общего запаса железа в организме. Кроме того, ферритин принимает участие в  иммунных процессах и  способен оказывать как провоспалительные, так и  противовоспалительные эффекты. Гиперферритинемия  – это состояние, которое характеризуется значимым повышением уровня ферритина в  крови. Подобное изменение лабораторных показателей является достаточно неспецифическим признаком, который возникает при иммуновоспалительных и инфекционных заболеваниях, а также при развитии перегрузки железом. Оно в т. ч. может сопутствовать течению новой коронавирусной инфекции (COVID-19) и хронического вирусного гепатита С (ХГС) у пациентов. Гиперферритинемия при двух вышеупомянутых заболеваниях может выступать как маркер более тяжелого течения и  развития неблагоприятных исходов у  пациентов, в  связи с  чем изучение уровня ферритина является крайне важной задачей для практикующего врача. В связи с этим целью данного обзора научной литературы было изучение возможной взаимосвязи трех описанных состояний. Согласно полученным данным, гиперферритинемия зачастую связана с развитием более тяжелого течения как COVID-19, так и ХГС, причем, по данным ряда исследований, в случае их одновременного сочетания риск развития летального исхода у пациента может повышаться. Исходя из этих данных был сделан важный вывод о необходимости измерения исходного уровня ферритина у таких пациентов с последующим его динамическим контролем.

Ferritin is one of the key proteins, which has involved in the regulation of iron homeostasis in the body. Ferritin reduced values are often associated with changes in the total iron supply in the body. In addition, ferritin is involved in immune processes and can have both pro-inflammatory and anti-inflammatory effects. Ferritin changes in laboratory values is a rather nonspecific sign that occurs with immunoinflammatory and infectious diseases, as well as the development of iron overload. It can, among other things, accompany the  course of  new coronavirus infection  (COVID-19) and chronic viral hepatitis C  (CHC) in  patients. Hyperferritinemia in these two diseases may be a marker of a more severe course and adverse patient outcome, making the study of ferritin levels an extremely important task for the practitioner. Therefore, the purpose of this review of the scientific literature was to investigate the possible relationship between Hyperferritinemia, COVID-19 and CHC. It has been reported that hyperferritinemia is quite often associated with a more severe form of both COVID-19 and CHC. Several studies have suggested that the risk of mortality may be increased if they are combined. In this regard, an important conclusion was made about measuring baseline ferritin levels with subsequent dynamic monitoring in this group of patients. 

новая коронавирусная инфекцияХГСферритингиперферритинемияповышение уровня ферритинавирус гепатита Сnew coronavirus infectionCHCferritinhyperferritinemiaelevated ferritin levelshepatitis C virusReferencesValenti L., Corradini E., Adams L.A., Aigner E., Alqahtani S., Arrese M. et al. Consensus Statement on the definition and classification of metabolic hyperferritinaemia. Nat Rev Endocrinol. 2023;17:1–12. https://doi.org/10.1038/s41574-023-00807-6.Valenti L., Corradini E., Adams L.A., Aigner E., Alqahtani S., Arrese M. et al. Consensus Statement on the definition and classification of metabolic hyperferritinaemia. Nat Rev Endocrinol. 2023;17:1–12. https://doi.org/10.1038/s41574-023-00807-6.Adams P.C., Reboussin D.M., Barton J.C., McLaren C.E., Eckfeldt J.H., McLaren G.D. et al. Hemochromatosis and Iron Overload Screening (HEIRS) Study Research Investigators. Hemochromatosis and iron-overload screening in a racially diverse population. N Engl J Med. 2005;352(17):1769–1778. https://doi.org/10.1056/NEJMoa041534.Adams P.C., Reboussin D.M., Barton J.C., McLaren C.E., Eckfeldt J.H., McLaren G.D. et al. Hemochromatosis and Iron Overload Screening (HEIRS) Study Research Investigators. Hemochromatosis and iron-overload screening in a racially diverse population. N Engl J Med. 2005;352(17):1769–1778. https://doi.org/10.1056/NEJMoa041534.Zhou B., Liu S., Yuan G. Combined Associations of Serum Ferritin and Body Size Phenotypes With Cardiovascular Risk Profiles: A Chinese Population-Based Study. Front Public Health. 2021;9:550011. https://doi.org/10.3389/fpubh.2021.550011.Zhou B., Liu S., Yuan G. Combined Associations of Serum Ferritin and Body Size Phenotypes With Cardiovascular Risk Profiles: A Chinese PopulationBased Study. Front Public Health. 2021;9:550011. https://doi.org/10.3389/fpubh.2021.550011.Масленникова Г.Я., Оганов Р.Г. Профилактика неинфекционных заболеваний как возможность увеличения ожидаемой продолжительности жизни и здорового долголетия. Кардиоваскулярная терапия и профилактика. 2019;18(2):5–12. https://doi.org/10.15829/1728-8800-2019-2-5-12.Maslennikova G.Y., Oganov R.G. Prevention of non-infectious diseases as an opportunity to increase life expectancy and healthy longevity. Cardiovascular Therapy and Prevention (Russian Federation). 2019;18(2):5–12. (In Russ.) https://doi.org/10.15829/1728-8800-2019-2-5-12.Самородская И.В., Ключников И.В. Проблемы диагностики и лечения COVID-19 на клиническом примере. Врач. 2020;(4):19–25. https://doi.org/10.29296/25877305-2020-04-04.Samorodskaya I.V., Klyuchnikov I.V. Problems of diagnosis and treatment of COVID-19 by clinical example. Vrach. 2020;(4):19–25. (In Russ.) https://doi.org/10.29296/25877305-2020-04-04.Lazar A.M. Hyperferritinemia: The Link Between COVID-19, Inflammation, and Patient Comorbidities. IDHealth. 2021;4(4):615–622. https://doi.org/10.47108/jidhealth.Vol4.Iss4.193.Lazar A.M. Hyperferritinemia: The Link Between COVID-19, Inflammation, and Patient Comorbidities. IDHealth. 2021;4(4):615–622. https://doi.org/10.47108/jidhealth.Vol4.Iss4.193.Богомолов П.О., Сапанюк А.И., Буеверов А.О., Висков Р.В., Соболев К.Э., Ушканенко И.Н. и др. Организация медицинской помощи пациентам с заболеваниями печени в Московской области. Вестник Росздравнадзора. 2022;(6):19–27. Режим доступа: https://www.roszdravnadzor.gov.ru/i/upload/images/2023/2/5/1675624939.70676-1-1410742.pdf.Bogomolov P.O., Sapanyuk A.I., Bueverov A.O., Viskov R.V., Sobolev K.E., Ushkanenko I.N. et al. Organization of medical care for patients with liver diseases in the Moscow region. Vestnik Roszdravnadzora. 2022;(6):19–27. (In Russ.) Available at: https://www.roszdravnadzor.gov.ru/i/upload/images/2023/2/5/1675624939.70676-1-1410742.pdf.Саркисянц Н.К., Григорян Э.Г. Прогностическая значимость уровня ферритинемии у больных хроническим гепатитом С. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2013;23(3):56–59. Режим доступа: http://old-gastro-j.ru/files/_3_2013_s9_1372602993.pdf.Sarkisyants N.K., Grigoryan E.G. Prognostic significance of ferritinemia level in patients with chronic hepatitis C. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2013;23(3):56–59. (In Russ.) Available at: http://old-gastro-j.ru/files/_3_2013_s9_1372602993.pdf.Цветаева Н.В., Левина А.А., Мамукова Ю.И. Основы регуляции обмена железа. Клиническая онкогематология. Фундаментальные исследования и клиническая практика. 2010;3(3):278–283. Режим доступа: https://www.elibrary.ru/item.asp?edn=mwezqf.Tsvetaeva N.V., Levina A.A., Mamukova Y.I. Fundamentals of regulation of iron metabolism. Clinical Oncohematology. Fundamental Research and Clinical Practice. 2010;3(3):278–283. (In Russ.) Available at: https://www.elibrary.ru/item.asp?edn=mwezqf.Sandnes M., Ulvik R.J., Vorland M., Reikvam H. Hyperferritinemia – A Clinical Overview. J Clin Med. 2021;10(9):2008. https://doi.org/10.3390/jcm10092008.Sandnes M., Ulvik R.J., Vorland M., Reikvam H. Hyperferritinemia – A Clinical Overview. J Clin Med. 2021;10(9):2008. https://doi.org/10.3390/jcm10092008.Perricone C., Bartoloni E., Bursi R., Cafaro G., Guidelli G.M., Shoenfeld Y., Gerli R. COVID-19 as part of the hyperferritinemic syndromes: the role of iron depletion therapy. Immunol Res. 2020;68(4):213–224. https://doi.org/10.1007/s12026-020-09145-5.Perricone C., Bartoloni E., Bursi R., Cafaro G., Guidelli G.M., Shoenfeld Y., Gerli R. COVID-19 as part of the hyperferritinemic syndromes: the role of iron depletion therapy. Immunol Res. 2020;68(4):213–224. https://doi.org/10.1007/s12026-020-09145-5.Каледа М.И., Федоров Е.С. Значение гиперферритинемии как диагностического и прогностического биомаркера. Современная ревматология. 2022;16(2):74–80. https://doi.org/10.14412/1996-7012-2022-2-74-80.Kaleda M.I., Fedorov E.С. Value of hyperferritinemia as a diagnostic and prognostic biomarker. Modern Rheumatology. 2022;16(2):74–80. (In Russ.) https://doi.org/10.14412/1996-7012-2022-2-74-80.Ruscitti P., Di Benedetto P., Berardicurti O., Panzera N., Grazia N., Lizzi A.R. et al. Pro-inflammatory properties of H-ferritin on human macrophages, ex vivo and in vitro observations. Sci Rep. 2020;10:12232. https://doi.org/10.1038/s41598-020-69031-w.Ruscitti P., Di Benedetto P., Berardicurti O., Panzera N., Grazia N., Lizzi A.R. et al. Pro-inflammatory properties of H-ferritin on human macrophages, ex vivo and in vitro observations. Sci Rep. 2020;10:12232. https://doi.org/10.1038/s41598-020-69031-w.Cheng L., Li H., Li L., Liu C., Yan S., Chen H., Li Y. Ferritin in the coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis. J Clin Lab Anal. 2020;34:e23618. https://doi.org/10.1002/jcla.23618.Cheng L., Li H., Li L., Liu C., Yan S., Chen H., Li Y. Ferritin in the coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis. J Clin Lab Anal. 2020;34:e23618. https://doi.org/10.1002/jcla.23618.Moreira A.C., Mesquita G., Gomes M.S. Ferritin: An Inflammatory Player Keeping Iron at the Core of Pathogen-Host Interactions. Microorganisms. 2020;8:589. https://doi.org/10.3390/microorganisms8040589.Moreira A.C., Mesquita G., Gomes M.S. Ferritin: An Inflammatory Player Keeping Iron at the Core of Pathogen-Host Interactions. Microorganisms. 2020;8:589. https://doi.org/10.3390/microorganisms8040589.Deng F., Zhang L., Lyu L., Lu Z., Gao D., Ma X. et al. Increased levels of ferritin on admission predicts intensive care unit mortality in patients with COVID-19. Med Clin (Barc). 2021;156(7):324–331. https://doi.org/10.1016/j.medcli.2020.11.030.Deng F., Zhang L., Lyu L., Lu Z., Gao D., Ma X. et al. Increased levels of ferritin on admission predicts intensive care unit mortality in patients with COVID-19. Med Clin (Barc). 2021;156(7):324–331. https://doi.org/10.1016/j.medcli.2020.11.030.Alam J.M., Ali H. Significance of Ferritin as Biomarker in SARS Corona virus (COVID-19) infection and complications: A Review. Chem Res J. 2020;5(6):59–64. Available at: http://chemrj.org/download/vol-5-iss-6-2020/chemrj-2020-05-06-59-64.pdf.Alam J.M., Ali H. Significance of Ferritin as Biomarker in SARS Corona virus (COVID-19) infection and complications: A Review. Chem Res J. 2020;5(6):59–64. Available at: http://chemrj.org/download/vol-5-iss-6-2020/chemrj-2020-05-06-59-64.pdf.Plays M., Müller S., Rodriguez R. Chemistry and biology of ferritin. Metallomics. 2021;13(5):mfab021. https://doi.org/10.1093/mtomcs/mfab021.Plays M., Müller S., Rodriguez R. Chemistry and biology of ferritin. Metallomics. 2021;13(5):mfab021. https://doi.org/10.1093/mtomcs/mfab021.Zhang J., Chen X., Hong J., Tang A., Liu Y., Xie N. et al. Biochemistry of mammalian ferritins in the regulation of cellular iron homeostasis and oxidative responses. Sci China Life Sci. 2021;64(3):352–362. https://doi.org/10.1007/s11427-020-1795-4.Zhang J., Chen X., Hong J., Tang A., Liu Y., Xie N. et al. Biochemistry of mammalian ferritins in the regulation of cellular iron homeostasis and oxidative responses. Sci China Life Sci. 2021;64(3):352–362. https://doi.org/10.1007/s11427-020-1795-4.Habib H.M., Ibrahim S., Zaim A., Ibrahim W.H. The role of iron in the pathogenesis of COVID-19 and possible treatment with lactoferrin and other iron chelators. Biomed Pharmacother. 2021;136:111228. https://doi.org/10.1016/j.biopha.2021.111228.Habib H.M., Ibrahim S., Zaim A., Ibrahim W.H. The role of iron in the pathogenesis of COVID-19 and possible treatment with lactoferrin and other iron chelators. Biomed Pharmacother. 2021;136:111228. https://doi.org/10.1016/j.biopha.2021.111228.Birndt S., Schenk T., Heinevetter B., Brunkhorst F.M., Maschmeyer G., Rothmann F. et al. Hemophagocytic lymphohistiocytosis in adults: collaborative analysis of 137 cases of a nationwide. German registry. J Cancer Res Clin Oncol. 2020;146:1065–1077. https://doi.org/10.1007/s00432-020-03139-4.Birndt S., Schenk T., Heinevetter B., Brunkhorst F.M., Maschmeyer G., Rothmann F. et al. Hemophagocytic lymphohistiocytosis in adults: collaborative analysis of 137 cases of a nationwide. German registry. J Cancer Res Clin Oncol. 2020;146:1065–1077. https://doi.org/10.1007/s00432-020-03139-4.Schulert G.S., Canna S.W. Convergent pathways of the hyperferritinemic syndromes. Int Immunol. 2018;30:195–203. https://doi.org/10.1093/intimm/dxy012.Schulert G.S., Canna S.W. Convergent pathways of the hyperferritinemic syndromes. Int Immunol. 2018;30:195–203. https://doi.org/10.1093/intimm/dxy012.Tran T.N., Eubanks S.K., Schaffer K.J., Zhou C.Y., Linder M.C. Secretion of Ferritin by Rat Hepatoma Cells and Its Regulation by Inflammatory Cytokines and Iron. Blood. 1997;90(12):4979–4986. https://doi.org/10.1182/blood.V90.12.4979.Tran T.N., Eubanks S.K., Schaffer K.J., Zhou C.Y., Linder M.C. Secretion of Ferritin by Rat Hepatoma Cells and Its Regulation by Inflammatory Cytokines and Iron. Blood. 1997;90(12):4979–4986. https://doi.org/10.1182/blood.V90.12.4979.Torti F.M., Torti S.V. Regulation of ferritin genes and protein. Blood. 2002;99(10):3505–3516. https://doi.org/10.1182/blood.v99.10.3505.Torti F.M., Torti S.V. Regulation of ferritin genes and protein. Blood. 2002;99(10):3505–3516. https://doi.org/10.1182/blood.v99.10.3505.Kernan K.F., Carcillo J.A. Hyperferritinemia and inflammation. Int Immunol. 2017;29(9):401–409. https://doi.org/https://doi.org/10.1093/intimm/dxx031.Kernan K.F., Carcillo J.A. Hyperferritinemia and inflammation. Int Immunol. 2017;29(9):401–409. https://doi.org/https://doi.org/10.1093/intimm/dxx031.Rosário C., Zandman-Goddard G., Meyron-Holtz E.G., D’Cruz D.P., Shoenfeld Y. The hyperferritinemic syndrome: macrophage activation syndrome, Still’s disease, septic shock and catastrophic antiphospholipid syndrome. BMC Med. 2013;11:185. https://doi.org/10.1186/1741-7015-11-185.Rosário C., Zandman-Goddard G., Meyron-Holtz E.G., D’Cruz D.P., Shoenfeld Y. The hyperferritinemic syndrome: macrophage activation syndrome, Still’s disease, septic shock and catastrophic antiphospholipid syndrome. BMC Med. 2013;11:185. https://doi.org/10.1186/1741-7015-11-185.Para O., Caruso L., Pestelli G., Tangianu F., Carrara D., Maddaluni L. et al. Ferritin as prognostic marker in COVID-19: the FerVid study. Postgrad Med. 2022;134(1):58–63. https://doi.org/10.1080/00325481.2021.1990091.Para O., Caruso L., Pestelli G., Tangianu F., Carrara D., Maddaluni L. et al. Ferritin as prognostic marker in COVID-19: the FerVid study. Postgrad Med. 2022;134(1):58–63. https://doi.org/10.1080/00325481.2021.1990091.Gómez-Pastora J., Weigand M., Kim J., Wu X., Strayer J., Palmer A.F. et al. Hyperferritinemia in critically ill COVID-19 patients - Is ferritin the product of inflammation or a pathogenic mediator? Clin Chim Acta. 2020;509:249–251. https://doi.org/10.1016/j.cca.2020.06.033.Gómez-Pastora J., Weigand M., Kim J., Wu X., Strayer J., Palmer A.F. et al. Hyperferritinemia in critically ill COVID-19 patients - Is ferritin the product of inflammation or a pathogenic mediator? Clin Chim Acta. 2020;509:249–251. https://doi.org/10.1016/j.cca.2020.06.033.Kappert K., Jahić A., Tauber R. Assessment of serum ferritin as a biomarker in COVID-19: bystander or participant? Insights by comparison with other infectious and non-infectious diseases. Biomarkers. 2020;25(8):616–625. https://doi.org/10.1080/1354750X.2020.1797880.Kappert K., Jahić A., Tauber R. Assessment of serum ferritin as a biomarker in COVID-19: bystander or participant? Insights by comparison with other infectious and non-infectious diseases. Biomarkers. 2020;25(8):616–625. https://doi.org/10.1080/1354750X.2020.1797880.Cavezzi A., Troiani E., Corrao S. COVID-19: hemoglobin, iron, and hypoxia beyond inflammation. A narrative review. Clin Pract. 2020;10(2):1271. https://doi.org/10.4081/cp.2020.1271.Cavezzi A., Troiani E., Corrao S. COVID-19: hemoglobin, iron, and hypoxia beyond inflammation. A narrative review. Clin Pract. 2020;10(2):1271. https://doi.org/10.4081/cp.2020.1271.Čepelak I., Dodig S., Vučenik I. Hyperferritinemia and COVID-19? RAD CASA – Medical Sciences. 2020;544:18–25. https://doi.org/10.21857/ygjwrcdv0y.Čepelak I., Dodig S., Vučenik I. Hyperferritinemia and COVID-19? RAD CASA – Medical Sciences. 2020;544:18–25. https://doi.org/10.21857/ygjwrcdv0y.Zou D.M., Sun W.L. Relationship between Hepatitis C Virus Infection and Iron Overload. Chin Med J (Engl). 2017;130(7):866–871. https://doi.org/10.4103/0366-6999.202737.Zou D.M., Sun W.L. Relationship between Hepatitis C Virus Infection and Iron Overload. Chin Med J (Engl). 2017;130(7):866–871. https://doi.org/10.4103/0366-6999.202737.Kakizaki S., Takagi H., Horiguchi N., Toyoda M., Takayama H., Nagamine T. et al. Iron enhances hepatitis C virus replication in cultured human hepatocytes. Liver. 2000;20(2):125–128. https://doi.org/10.1034/j.1600-0676.2000.020002125.x.Kakizaki S., Takagi H., Horiguchi N., Toyoda M., Takayama H., Nagamine T. et al. Iron enhances hepatitis C virus replication in cultured human hepatocytes. Liver. 2000;20(2):125–128. https://doi.org/10.1034/j.1600-0676.2000.020002125.x.Foka P., Dimitriadis A., Karamichali E., Kyratzopoulou E., Giannimaras D., Koskinas J. et al. Alterations in the iron homeostasis network: A driving force for macrophage-mediated hepatitis C virus persistency. Virulence. 2016;7:679-690. https://doi.org/10.1080/21505594.2016.1175700.Foka P., Dimitriadis A., Karamichali E., Kyratzopoulou E., Giannimaras D., Koskinas J. et al. Alterations in the iron homeostasis network: A driving force for macrophage-mediated hepatitis C virus persistency. Virulence. 2016;7:679-690. https://doi.org/10.1080/21505594.2016.1175700.Fillebeen C., Pantopoulos K. Iron inhibits replication of infectious hepatitis C virus in permissive Huh7.5.1 cells. J Hepatol. 2010;53:995-999. https://doi.org/10.1016/j.jhep.2010.04.044.Fillebeen C., Pantopoulos K. Iron inhibits replication of infectious hepatitis C virus in permissive Huh7.5.1 cells. J Hepatol. 2010;53:995-999. https://doi.org/10.1016/j.jhep.2010.04.044.Di Bisceglie A.M., Axiotis C.A., Hoofnagle J.H., Bacon B.R. Measurements of iron status in patients with chronic hepatitis. Gastroenterology. 1992;102(6):2108–2113. https://doi.org/10.1016/0016-5085(92)90339-z.Di Bisceglie A.M., Axiotis C.A., Hoofnagle J.H., Bacon B.R. Measurements of iron status in patients with chronic hepatitis. Gastroenterology. 1992;102(6):2108–2113. https://doi.org/10.1016/0016-5085(92)90339-z.Hézode C., Cazeneuve C., Coué O., Roudot-Thoraval F., Lonjon I., Bastie A. et al. Liver iron accumulation in patients with chronic active hepatitis C: prevalence and role of hemochromatosis gene mutations and relationship with hepatic histological lesions. J Hepatol. 1999;31(6):979–984. https://doi.org/10.1016/s0168-8278(99)80308-0.Hézode C., Cazeneuve C., Coué O., Roudot-Thoraval F., Lonjon I., Bastie A. et al. Liver iron accumulation in patients with chronic active hepatitis C: prevalence and role of hemochromatosis gene mutations and relationship with hepatic histological lesions. J Hepatol. 1999;31(6):979–984. https://doi.org/10.1016/s0168-8278(99)80308-0.Nishina S., Hino K., Korenaga M., Vecchi C., Pietrangelo A., Mizukami Y. et al. Hepatitis C virus-induced reactive oxygen species raise hepatic iron level in mice by reducing hepcidin transcription. Gastroenterology. 2008;134(1):226–238. https://doi.org/10.1053/j.gastro.2007.10.011.Nishina S., Hino K., Korenaga M., Vecchi C., Pietrangelo A., Mizukami Y. et al. Hepatitis C virus-induced reactive oxygen species raise hepatic iron level in mice by reducing hepcidin transcription. Gastroenterology. 2008;134(1):226–238. https://doi.org/10.1053/j.gastro.2007.10.011.Miura K., Taura K., Kodama Y., Schnabl B., Brenner D.A. Hepatitis C virusinduced oxidative stress suppresses hepcidin expression through increased histone deacetylase activity. Hepatology. 2008;48(5):1420–1429. https://doi.org/10.1002/hep.22486.Miura K., Taura K., Kodama Y., Schnabl B., Brenner D.A. Hepatitis C virusinduced oxidative stress suppresses hepcidin expression through increased histone deacetylase activity. Hepatology. 2008;48(5):1420–1429. https://doi.org/10.1002/hep.22486.Taher A.T., Saliba A.N. Iron overload in thalassemia: different organs at different rates. Hematology Am Soc Hematol Educ Program. 2017;2017(1):265–271. https://doi.org/10.1182/asheducation-2017.1.265.Taher A.T., Saliba A.N. Iron overload in thalassemia: different organs at different rates. Hematology Am Soc Hematol Educ Program. 2017;2017(1):265–271. https://doi.org/10.1182/asheducation-2017.1.265.Metwally M.A., Zein C.O., Zein N.N. Clinical significance of hepatic iron deposition and serum iron values in patients with chronic hepatitis C infection. Am J Gastroenterol. 2004;99:286-291. https://doi.org/10.1111/j.1572-0241.2004.04049.x.Metwally M.A., Zein C.O., Zein N.N. Clinical significance of hepatic iron deposition and serum iron values in patients with chronic hepatitis C infection. Am J Gastroenterol. 2004;99:286-291. https://doi.org/10.1111/j.1572-0241.2004.04049.x.Щекотова А.П., Булатова И.А. Вклад изменений обмена железа в патогенез хронических диффузных заболеваний печени. Пермский медицинский журнал. 2020;37(6):5–12. https://doi.org/10.17816/pmj3765-12.Shchekotova A.P., Bulatova I.A. Contribution of iron metabolism changes to the pathogenesis of chronic diffuse liver diseases. Perm Medical Journal. 2020;37(6):5–12. (In Russ.) https://doi.org/10.17816/pmj3765-12.Inomata S., Anan A., Yamauchi E., Yamauchi R., Kunimoto H., Takata K. et al. Changes in the Serum Hepcidin-to-ferritin Ratio with Erythroferrone after Hepatitis C Virus Eradication Using Direct-acting Antiviral Agents. Intern Med. 2019;58(20):2915–2922. https://doi.org/10.2169/internalmedicine.2909-19.Inomata S., Anan A., Yamauchi E., Yamauchi R., Kunimoto H., Takata K. et al. Changes in the Serum Hepcidin-to-ferritin Ratio with Erythroferrone after Hepatitis C Virus Eradication Using Direct-acting Antiviral Agents. Intern Med. 2019;58(20):2915–2922. https://doi.org/10.2169/internalmedicine.2909-19.Tan T.C., Crawford D.H., Franklin M.E., Jaskowski L.A., Macdonald G.A., Jonsson J.R. et al. The serum hepcidin:ferritin ratio is a potential biomarker for cirrhosis. Liver Int. 2012;32(9):1391–1399. https://doi.org/10.1111/j.1478-3231.2012.02828.x.Tan T.C., Crawford D.H., Franklin M.E., Jaskowski L.A., Macdonald G.A., Jonsson J.R. et al. The serum hepcidin:ferritin ratio is a potential biomarker for cirrhosis. Liver Int. 2012;32(9):1391–1399. https://doi.org/10.1111/j.1478-3231.2012.02828.x.Martinez M.A., Franco S. Impact of COVID-19 in Liver Disease Progression. Hepatol Commun. 2021;5(7):1138–1150. https://doi.org/10.1002/hep4.1745.Martinez M.A., Franco S. Impact of COVID-19 in Liver Disease Progression. Hepatol Commun. 2021;5(7):1138–1150. https://doi.org/10.1002/hep4.1745.Беляков Н.А., Боева Е.В., Загдын З.М., Эсауленко Е.В., Лиознов Д.А., Симакина О.Е. и др. Эпидемиология и течение инфекционных заболеваний на фоне пандемии COVID-19. Сообщение 1. ВИЧ-инфекция, хронический гепатит С и туберкулез. Инфекция и иммунитет. 2022;12(4):639–650. https://doi.org/10.15789/2220-7619-EAC-1958.Belyakov N.A., Boeva E.V., Zagdyn Z.M., Esaulenko E.V., Lioznov D.A., Simakina O.E. Epidemiology and course of infectious diseases against the background of COVID-19 pandemic. 1. HIV infection, chronic hepatitis C and tuberculosis. Russian Journal of Infection and Immunity. 2022;12(4):639–650. (In Russ.) https://doi.org/10.15789/2220-7619-EAC-1958.Jang T.Y. Suppression of hepatitis C virus replication during COVID-19 infection. Kaohsiung J Med Sci. 2022;38(4):394–395. https://doi.org/10.1002/kjm2.12498.Jang T.Y. Suppression of hepatitis C virus replication during COVID-19 infection. Kaohsiung J Med Sci. 2022;38(4):394–395. https://doi.org/10.1002/kjm2.12498.Toma L., Zgura A., Isac T., Simu R., Mercan-Stanciu A., Dodot M., Iliescu E.L. COVID-19 and the thyroid function in patients with HCV-associated hepatocellular carcinoma. Acta Endocrinol (Buchar). 2022;18(3):392–396. https://doi.org/10.4183/aeb.2022.392.Toma L., Zgura A., Isac T., Simu R., Mercan-Stanciu A., Dodot M., Iliescu E.L. COVID-19 and the thyroid function in patients with HCV-associated hepatocellular carcinoma. Acta Endocrinol (Buchar). 2022;18(3):392–396. https://doi.org/10.4183/aeb.2022.392.Mangia A., Cenderello G., Verucchi G., Ciancio A., Fontana A., Piazzolla V. et al. Is positivity for hepatitis C virus antibody predictive of lower risk of death in COVID-19 patients with cirrhosis? World J Clin Cases. 2020;8(22):5831–5834. https://doi.org/10.12998/wjcc.v8.i22.5831.Mangia A., Cenderello G., Verucchi G., Ciancio A., Fontana A., Piazzolla V. et al. Is positivity for hepatitis C virus antibody predictive of lower risk of death in COVID-19 patients with cirrhosis? World J Clin Cases. 2020;8(22):5831–5834. https://doi.org/10.12998/wjcc.v8.i22.5831.Ronderos D., Omar A.M.S., Abbas H., Makker J., Baiomi A., Sun H. et al. Chronic hepatitis-C infection in COVID-19 patients is associated with in-hospital mortality. World J Clin Cases. 2021;9(29):8749–8762. https://doi.org/10.12998/wjcc.v9.i29.8749.Ronderos D., Omar A.M.S., Abbas H., Makker J., Baiomi A., Sun H. et al. Chronic hepatitis-C infection in COVID-19 patients is associated with in-hospital mortality. World J Clin Cases. 2021;9(29):8749–8762. https://doi.org/10.12998/wjcc.v9.i29.8749.

The authors declare that there are no conflicts of interest present.