Author/Authors :
Onali Simona نويسنده Department of Medical Sciences and Public Health,
University of Cagliari, Cagliari, Italy , Maida Ivana نويسنده Department of Clinical and Experimental Medicine,
University of Sassari, Sassari, Italy , Balestrieri Cinzia نويسنده Liver Unit, Department of Internal Medicine, University
Hospital of Cagliari, Cagliari, Italy , Arcadu Francesco نويسنده Internal Medicine and Gastroenterology, San Francesco
Hospital, ASL 3, Nuoro, Italy , Urru Enrico نويسنده Department of Medical Sciences and Public Health,
University of Cagliari, Cagliari, Italy , Porcu Davide نويسنده Department of Medical Sciences and Public Health,
University of Cagliari, Cagliari, Italy , Serra Giancarlo نويسنده Liver Unit, Department of Internal Medicine, University
Hospital of Cagliari, Cagliari, Italy , Flore Giacomo نويسنده Department of Clinical and Experimental Medicine,
University of Sassari, Sassari, Italy , Dore Elena نويسنده Department of Clinical and Experimental Medicine,
University of Sassari, Sassari, Italy , Satta Caterina نويسنده Internal Medicine and Gastroenterology, San Francesco
Hospital, ASL 3, Nuoro, Italy , Paolo Bitti Pier نويسنده Immunohematology and Transfusional Medicine, San Francesco
Hospital, ASL 3, Nuoro, Italy , Grazia Sanna Maria نويسنده Immunohematology and Transfusional Medicine, San Francesco
Hospital, ASL 3, Nuoro, Italy , Serusi Loredana نويسنده Immunohematology and Transfusional Medicine, San Francesco
Hospital, ASL 3, Nuoro, Italy , Casale Michele نويسنده Department of Medical Sciences and Public Health,
University of Cagliari, Cagliari, Italy , Conti Maria نويسنده Liver Unit, Department of Internal Medicine, University
Hospital of Cagliari, Cagliari, Italy , Loi Martina نويسنده Department of Medical Sciences and Public Health,
University of Cagliari, Cagliari, Italy , Figorilli Francesco نويسنده Department of Medical Sciences and Public Health,
University of Cagliari, Cagliari, Italy , Cristina Pasetto Maria نويسنده Department of Medical Sciences and Public Health,
University of Cagliari, Cagliari, Italy , Babudieri Sergio نويسنده Department of Clinical and Experimental Medicine,
University of Sassari, Sassari, Italy , Chessa Luchino نويسنده Department of Medical Sciences and Public Health,
University of Cagliari, Cagliari, Italy
Abstract :
Background Hepatitis C virus (HCV) infection is a major cause of
liver-related morbidity and mortality among thalassemic patients. New
treatments based on direct-acting antivirals (DAAs) are highly effective
and well-tolerated by patients; nonetheless, they have not been studied
in thalassemic populations. In this study, we evaluated the safety and
efficacy of these treatments in a cohort of Sardinian thalassemic
patients with chronic HCV infection. Methods We consecutively recruited
thalassemic patients with HCV infection, who were eligible for DAA
therapy at 3 liver units. Different drug combinations, depending on HCV
genotype and hepatic disease severity, were used according to the
current guidelines. Sustained virological response was assessed at 12
weeks posttreatment. Data regarding the side effects and transfusion
requirements were also collected. Results We recruited 49 patients,
including 29 males (59.2%), with the mean age of 43 years (genotype 1,
55.1%). Twenty-one (42.9%) patients had a history of interferon-based
treatment. Cirrhosis was detected in 28 (57.1%) patients; only 1 patient
had ascites and hypoalbuminemia (Child-Pugh B7). On the other hand, 35
(71.4%) patients received a sofosbuvir-based regimen. Ribavirin
treatment was reported in 26 (53.1%) cases. All the patients were
followed-up for at least 12 weeks after therapy, and sustained
virological response was observed in 98% of the patients. No treatment
discontinuation was required due to adverse events. The most common side
effects included fatigue (24.5%), headache (10.2%), and anaemia (77%),
requiring further blood transfusion in patients receiving ribavirin.
Conclusions This prospective study showed that DAAs are safe and
effective agents in thalassemic patients with advanced liver fibrosis,
regardless of previous antiviral treatment responses.
