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Long-Term Efficacy of  -Interferon in  -Thalassemics With Chronic Hepatitis C
V. Di Marco,
O. Lo Iacono,
P. Almasio,
C. Ciaccio,
M. Capra,
M. Rizzo,
R. Malizia,
A. Maggio,
C. Fabiano,
F. Barbaria, and
A. Craxì
From the Cattedra di Medicina Interna (CLOPD), Istituto di Clinica Medica I, Università di Palermo, Palermo, Italy; the Centro Trasfusionale e di Talassemia Ospedale di Sciacca, Agrigento, Italy; the Centro di Talassemia, Ospedale Pediatrico G. Di Cristina, Palermo, Italy; the Centro di Talassemia, Ospedale S. Elia, Caltanissetta, Italy; the Centro di Talassemia, Ospedale Villa Sofia, Palermo, Italy; the Servizio Talassemia, Ospedale V. Cervello, Palermo, Italy; and the Divisione di Medicina, Ospedale V. Cervello, Palermo, Italy.
Hepatitis C virus (HCV) infection is a common cause of liver disease among polytransfused thalassemics. We treated a cohort of subjects with  -thalassemia major and chronic hepatitis C with  -interferon. The aims of the study were to assess the long-term biochemical and virologic efficacy of -interferon and to evaluate the influence of HCV type and liver siderosis on the outcome of therapy. Seventy subjects (mean age, 14.1 years) with chronic HCV infection and abnormal aminotransferases received recombinant -interferon for 12 months and were observed after therapy for at least 24 months. Sixty-three subjects (90%) were HCV-RNA positive at the start of therapy. HCV type 1b was found in 41 subjects (65.1%), non-1b types in 13 (20.6%), and mixed HCV types in 9 (14.3%). Liver biopsy showed cirrhosis in 11 subjects (15.7%) and siderosis grade 3-4 in 24 patients (34.2%). Three patients stopped therapy due to adverse events. Twenty-eight subjects (40%) had normal aminotransferases and had cleared HCV-RNA when last observed (mean follow-up, 36.5 months; range, 25 to 49 months). Of 41 patients who did not normalize aminotransferases, 9 had become HCV-RNA negative at the end of follow-up. The absence of cirrhosis, low liver iron content, and infection with non-1b HCV type were independently associated to complete sustained response upon multivariable analysis. In conclusion, -interferon may induce a sustained virologic and biochemical remission of hepatitis in -thalassemic patients with chronic HCV infection and nonadvanced liver disease.
Blood, Vol. 90 No. 6 (September 15), 1997:
pp. 2207-2212
© 1997 by The American Society of Hematology.
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