Hepatitis C in patients with β-thalassemia major. A single-centre experience

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• 作者：Christos Triantos (1)
  Alexandra Kourakli (2)
  Maria Kalafateli (1)
  Dimitra Giannakopoulou (1)
  Nikolaos Koukias (1)
  Konstantinos Thomopoulos (1)
  Polixeni Lampropoulou (2)
  Christina Bartzavali (3)
  Helen Fragopanagou (2)
  George C. Kagadis (4)
  Mirto Christofidou (3)
  Athanasios Tsamandas (5)
  Vasiliki Nikolopoulou (1)
  Marina Karakantza (2)
  Chryssoula Labropoulou-Karatza (6)
  
• 关键词：Thalassemia major ; Hepatitis C ; Liver fibrosis ; Interferon ; alpha ; Ribavirin
• 刊名：Annals of Hematology
• 出版年：2013
• 出版时间：June 2013
• 年：2013
• 卷：92
• 期：6
• 页码：739-746
• 全文大小：185KB
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• 作者单位：Christos Triantos (1)
  Alexandra Kourakli (2)
  Maria Kalafateli (1)
  Dimitra Giannakopoulou (1)
  Nikolaos Koukias (1)
  Konstantinos Thomopoulos (1)
  Polixeni Lampropoulou (2)
  Christina Bartzavali (3)
  Helen Fragopanagou (2)
  George C. Kagadis (4)
  Mirto Christofidou (3)
  Athanasios Tsamandas (5)
  Vasiliki Nikolopoulou (1)
  Marina Karakantza (2)
  Chryssoula Labropoulou-Karatza (6)
  
  1. Department of Gastroenterology, University Hospital of Patras, Stamatopoulou 4, Rio, 26504, Patras, Greece
  2. Department of Hematology, University Hospital of Patras, Patras, Greece
  3. Department of Microbiology, University Hospital of Patras, Patras, Greece
  4. Department of Medical Physics, School of Medicine, University of Patras, Patras, Greece
  5. Department of Pathology, University Hospital of Patras, Patras, Greece
  6. Department of Internal Medicine, University Hospital of Patras, Patras, Greece
  
• ISSN：1432-0584

文摘

Chronic hepatitis C (CHC) and iron overload are the main causes of liver disease in β-thalassemia major (βTM). There is limited data regarding the course of CHC in this population. All patients (n--44) from the thalassemia centre of the University Hospital of Patras were evaluated (January 1981 to June 2012). Patients were classified into group A (n--7), which consisted of patients with CHC, who either had received antiviral treatment (n--9) or not (n--), and group B which included 87 patients without CHC. Nineteen patients died during follow-up (median: 257.5?months (1-55)). Survival rates were 84.2?% and 88.5?% for group A and B, respectively. The causes of death were heart failure (63.2?%), accident (10.5?%), sepsis (5.3?%), liver failure (5.3?%), hepatocellular carcinoma (HCC) (5.3?%), non-Hodgkin lymphoma (5.3?%) and multiorgan failure (5.3?%). There were no differences in total survival between the two groups (p--.524). In the multivariate analysis, survival was neither correlated with CHC (p-?ns), nor with anti-HCV treatment (p-?ns), whereas independent negative predictors were presence of heart failure (p-lt;-.001), presence of malignancy other than HCC (p--.001) and non-adherence to chelation treatment (p--.013). Predictive factors for the development of cirrhosis were: CHC (p-lt;-.001), age-gt;-5?years (p--.007), siderosis grade 3/4 (p--.029) and splenectomy (p--.001); however, multivariately, only siderosis grade 3/4 was found to be significant (p--.049). In this study, survival of patients with βTM was mainly associated with heart failure, presence of malignancy other than HCC and non-adherence to chelation treatment, rather than with liver disease. Multicentre studies need to be designed to define more accurately the indications of antiviral treatment in this population.