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Dual therapy with peg-interferon and ribavirin in thalassemia major patients with chronic HCV infection: Is there still an indication?
- Source :
-
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver [Dig Liver Dis] 2016 Jun; Vol. 48 (6), pp. 650-5. Date of Electronic Publication: 2016 Feb 21. - Publication Year :
- 2016
-
Abstract
- Background: Iron overload and hepatitis C virus (HCV) infection together can lead to chronic liver damage in thalassemia major (TM) patients.<br />Aims: We investigated viral, genetic, and disease factors influencing sustained virological response (SVR) after peg-interferon and ribavirin therapy in TM patients with HCV infection.<br />Methods: We analyzed 230 TM patients with HCV infection (mean age 36.0±6.3 years; 59.1% genotype 1; 32.2% genotype 2; 3.4% genotype 3; and 5.3% genotype 4; 28.7% carried CC allele of rs12979860 in IL28B locus; 79.6% had chronic hepatitis and 20.4% cirrhosis; 63.5% naive and 36.5% previously treated with interferon alone) treated in 14 Italian centers.<br />Results: By multivariate regression analysis SVR was independently associated with CC allele of IL28B SNP (OR 2.98; CI 95% 1.29-6.86; p=0.010) and rapid virologic response (OR 11.82; CI 95% 3.83-36.54; p<0.001) in 136 genotype 1 patients. Combining favorable variables the probability of SVR ranged from 31% to 93%. In genotype 2 patients, only RVR (OR 8.61; CI 95% 2.85-26.01; p<0.001) was associated with SVR higher than 80%. In 3 patients with cirrhosis a decompensation of liver or heart disease were observed. Over 50% of patients increased blood transfusions.<br />Conclusion: Dual therapy in TM patients with chronic HCV infection is efficacious in patients with the best virological, genetic and clinical predictors. Patients with cirrhosis have an increased risk of worsening liver or heart disease.<br /> (Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Adult
Drug Therapy, Combination
Female
Heart Diseases complications
Hepacivirus genetics
Humans
Interferons
Interleukins genetics
Italy
Liver Cirrhosis drug therapy
Logistic Models
Male
Multivariate Analysis
Polymorphism, Single Nucleotide
Retrospective Studies
Treatment Outcome
Viral Load
beta-Thalassemia virology
Antiviral Agents therapeutic use
Hepatitis C, Chronic drug therapy
Interferon-alpha therapeutic use
Ribavirin therapeutic use
beta-Thalassemia complications
Subjects
Details
- Language :
- English
- ISSN :
- 1878-3562
- Volume :
- 48
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
- Publication Type :
- Academic Journal
- Accession number :
- 27012446
- Full Text :
- https://doi.org/10.1016/j.dld.2016.02.004