Natural history of hepatitis C in thalassemia major: a long‐term prospective study. (14th March 2013)

• Record Type: Journal Article
• Authors: Lai, Maria E.; Origa, Raffaella; Danjou, Fabrice; Leoni, Gian B.; Vacquer, Stefania; Anni, Franco; Corrias, Claudia; Farci, Patrizia; Congiu, Giovanna; Galanello, Renzo
• Is Part Of: European journal of haematology. Volume 90:Number 6(2013:Jun.)
• Page Start: 501
• Page End: 507
• Publication Date: 2013-03-14
• Subjects: beta‐thalassemia -- hepatitis C virus infection -- viral clearance -- interleukin‐28B -- fibrosis progression -- liver iron overload; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; Blood -- Periodicals; 616.15005
• DOI: 10.1111/ejh.12086
• Languages: English
• ISSNs: 0902-4441

Abstract

Abstract: Background: Transfusion‐acquired hepatitis C virus (HCV) remains an important problem among patients with thalassemia. In this study, we evaluated the natural history of post‐transfusional hepatitis C in thalassemia major, paying special attention to spontaneous viral clearance, to factors influencing the chronicity rate and fibrosis progression. Design and Methods: A prospective study to evaluate the incidence and etiology of transfusion‐related hepatitis was started in 1980. In patients who developed hepatitis C, HCV RNA, ALT, and ferritin were measured over time. The correlation between interleukin‐28B gene polymorphisms and viral clearance was also analyzed. Results: Seventy‐three of 135 patients (62.2%) acquired HCV. An extended follow‐up (22 to 30 yr) with HCV RNA assessment was available in 52 patients. Of them, 23 (44.2%) cleared the virus. The proportion of IL‐28B genotypes was different between the subjects who cleared the virus and the subjects who did not. Fibrosis progression was similar in HCV RNA–positive and HCV RNA–negative patients. Liver iron was the only factor associated with the fibrosis. Conclusions: In thalassemia patients with HCV infection, liver iron does not play a major role in influencing the chronicity rate, whereas it is significantly associated with the fibrosis.