Treatment and prevention of hepatitis B and C in thalassemia.

Patients with thalassemia have disturbances in hemoglobin chain production which leads to anemia requiring long-term and multiple transfusions, increasing the risk for transfusion-related viruses, including hepatitis B and C viruses. Although this transfusion-related risk has been virtually eliminated with optimal blood screening practices, a significant number of patients transfused prior to 1990 are infected with hepatitis C virus. Treatment of hepatitis B and hepatitis C has improved rapidly leading to viral eradication - or control of viral replication - with the aim of stopping the progression to liver cirrhosis and its complications. Treatment of chronic hepatitis B in patients with thalassemia does not differ from that of other patients. However, current treatment of hepatitis C necessitates the use of ribavirin, which is associated with dose-dependent hemolysis, requiring adjustment of the transfusion protocol for thalassemia patients during the treatment period. Several measures should be taken in thalassemia patients to prevent viral infection including vaccination for hepatitis B and adequate screening of blood and blood products.