Author/Authors :
Sandoughdaran، Saleh نويسنده Cardiac Surgery and Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran , , Alavian، Seyed-Moayed نويسنده , , Sharafi، Heidar نويسنده Molecular Division, Iran Hepatitis Network, Tehran, IR Iran , , Behnava، Bita نويسنده Baqiyatallah University of Medical Sciences, Baqiyatallah Research Center for Gastroenterology and Liver diseases, Tehran, IR Iran , , Salimi، Shima نويسنده Middle East Liver Disease Center, Tehran, IR Iran , , Mehrnoush، Leila نويسنده Middle East Liver Disease Center, Tehran, IR Iran , , Karimi Elizee، Pegah نويسنده Tehran Hepatitis Center, Tehran , , Keshvari، Maryam نويسنده Iranian Blood Transfusion Organization research Center, Tehran, IR Iran ,
Abstract :
Most thalassemic patients with chronic hepatitis C virus (HCV) infection do not respond to therapy with pegylated interferon (Peg-IFN) plus ribavirin (RBV) due to hepatic siderosis and RBV dose reduction caused by RBV-induced anemia. In the present study, we recruited HCV genotype 1-infected thalassemic patients who had relapsed after a 48-week treatment with Peg-IFN plus RBV in order to evaluate the efficacy of a 72-week regimen of Peg-IFN plus RBV. In this retrospective study, 23 thalassemic patients with HCV genotype 1 infection who had prior relapse after treatment with Peg-IFN and RBV for 48 weeks were consecutively enrolled in this study for evaluation of the efficacy of a 72-week treatment regimen. For the 21 included cases, mean age was 29.7 years; 81% were men and 28.6% had cirrhosis. At the end of the treatment, nine (42.9%) patients had an undetectable level of HCV RNA in their sera. However, six months after treatment completion four of these patients relapsed and a sustained virological response (SVR) was found in five (23.8%) patients. Undetectable HCV RNA level at week 4 (P = 0.03) and undetectable HCV RNA level at week 12 (P < 0.01) were found to be predictors of SVR. There was an average 47.9% increase in blood transfusion during therapy and treatment was discontinued for 12 (57.1%) patients prematurely. The present study suggests that thalassemic patients with chronic hepatitis C genotype 1 infection who did not achieve SVR after a course of therapy with Peg-IFN and RBV may benefit from being retreated with a 72-week regimen.
