Document Detail

Treatment of hepatitis C virus infection in thalassemia.
MedLine Citation:
PMID:  16339677     Owner:  NLM     Status:  MEDLINE    
Treatment of hepatitis C virus (HCV) in the general population has improved over the last decade. Patients treated with peginterferon alfa (PegIFN) and ribavirin (RBV) combination therapy demonstrate overall 50-55% sustained viral response (SVR) with rates as high as 80% in patients with genotypes 2 and 3. Because RBV induces hemolysis and subsequently increases blood transfusion requirements, combination therapy has been considered contraindicated for hemoglobinopathies. This report reviews the response to interferon alfa and RBV (IFN/RBV) and PegIFN/RBV combination therapies in patients treated in the Northern California Comprehensive Thalassemia Center. A total of six thalassemia major patients were treated with IFN/RBV (n = 5; age: 4-38 years) or with PegIFN/RBV (n = 1; age: 26 years). Quantitative HCV RNA polymerase chain reaction and liver iron level assessment were completed. Transfusion volumes were obtained from patients' medical records. On IFN/RBV combination, four of five patients demonstrated SVR. The one patient on PegIFN/RBV showed end-treatment viral response after 6 months of therapy (genotype 3), but subsequently relapsed. Liver iron pretreatment level ranged from 0.2 to 22 mg/g dry weight, with a mean +/- SD of 7.9 +/- 7.7. Transfusion requirement increased by a median of 43.5% (range: 32-137%). Five of the six patients had liver iron measurements within 1 year following completion of treatment, with quantitative liver iron increasing in two patients by 2.5 mg/g dry weight, decreasing in two patients by 3 and 14 mg/g dry weight, and remaining unchanged in one patient. All patients were able to complete combination therapy, although dose reductions were required. Patients with thalassemia and high iron overload can obtain SVR after combination therapy with rates similar to those in the general population and without significant complications. Although transfusion requirements increased in most patients, iron burden was not necessarily increased.
Ellen Butensky; Zahra Pakbaz; Drucilla Foote; Mark C Walters; Elliott P Vichinsky; Paul Harmatz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of the New York Academy of Sciences     Volume:  1054     ISSN:  0077-8923     ISO Abbreviation:  Ann. N. Y. Acad. Sci.     Publication Date:  2005  
Date Detail:
Created Date:  2005-12-12     Completed Date:  2006-07-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7506858     Medline TA:  Ann N Y Acad Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  290-9     Citation Subset:  IM    
Department of Gastroenterology and Nutrition, Children's Hospital & Research Center at Oakland, 747 52nd St., Oakland, CA 94609, USA.
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MeSH Terms
Antiviral Agents / administration & dosage,  therapeutic use*
Biopsy, Needle
Blood Transfusion / adverse effects
Bone Marrow Transplantation
Child, Preschool
Cord Blood Stem Cell Transplantation
Drug Therapy, Combination
Hepatitis C, Chronic / complications,  drug therapy*,  pathology
Interferon-alpha / administration & dosage,  therapeutic use*
Iron / analysis
Iron Overload / etiology,  pathology
Liver / chemistry,  pathology
Magnetic Resonance Imaging
Mass Spectrometry / methods
Polyethylene Glycols / administration & dosage,  therapeutic use
Ribavirin / administration & dosage,  therapeutic use*
Thalassemia / complications*,  surgery,  therapy
Treatment Outcome
Viremia / complications,  drug therapy*,  pathology
Reg. No./Substance:
0/Antiviral Agents; 0/Interferon-alpha; 0/Polyethylene Glycols; 36791-04-5/Ribavirin; 7439-89-6/Iron

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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