Resumen

Background: HCV infection and transfusional iron overload in Thalassemic patients may result in liver disease. HCV treatment in Thalassemia has raised safety concerns. Aim: Estimate effectiveness and tolerability of interferon-based therapy in HCV-infected Thalassemic patients. Material and methods: Over a 12-year period, consecutive patients with βThalassemia major (TM) and chronic hepatitis C received treatment. Liver biopsy, HCV-RNA and genotyping were performed beforehand. Sustained virological response (SVR) was defined as negative HCV-RNA 6 months post-treatment. Forty eight patients (26 M-22 F, mean age 39.8) were enrolled. Twenty nine patients were treated with conventional interferon alpha (IFNa) for 48 weeks (group A). Nineteen patients (10 naïve-9 previously IFNa experienced) received pegylated interferon (PEGIFN) (group B). Results: HCV-1 was found in 44%, HCV-2 in 14%, HCV-3 in 23% and HCV-4 in 19%. Group A: ten patients (38.5%) achieved SVR, 2 (7.5%) relapsed and 17 (54%) were non responders. Group B: five (28%) achieved SVR, 8 (44%) relapsed and 6 (28%) never responded. High HCV-RNA levels, genotype 1 and advanced liver fibrosis were independently associated with no response. Four patients (3 treated with IFNα, 1 with PEG-IFN) had to discontinue treatment due to complications. Conclusions: The response rate of IFN monotherapy in multi-transfused, HCV-infected Thalassemic patients is not inferior to that in nonmulti-transfused patients. IFNa administration is well-tolerated and should be recommended as initial treatment schedule in this setting.

Palabras clave: Anemia HCV infection antiviral treatment pegylated interferon thalassemia.

2013-07-12   |   559 visitas   |   Evalua este artículo 0 valoraciones

Vol. 12 Núm.4. Julio-Agosto 2013 Pags. 532-538 Ann Hepatol 2013; 12(4)