Treatment of chronic hepatitis C with direct‐acting antivirals in patients with β‐thalassaemia major and advanced liver disease. (25th April 2017)

• Record Type: Journal Article
• Authors: Sinakos, Emmanouil; Kountouras, Dimitrios; Koskinas, John; Zachou, Kalliopi; Karatapanis, Stylianos; Triantos, Christos; Vassiliadis, Themistoklis; Goulis, Ioannis; Kourakli, Alexandra; Vlachaki, Efthymia; Toli, Barbara; Tampaki, Maria; Arvaniti, Pinelopi; Tsiaoussis, Georgios; Bellou, Aristea; Kattamis, Antonis; Maragkos, Konstantinos; Petropoulou, Foteini; Dalekos, George N.; Akriviadis, Evangelos; Papatheodoridis, George V.
• Is Part Of: British journal of haematology. Volume 178:Number 1(2017)
• Page Start: 130
• Page End: 136
• Publication Date: 2017-04-25
• Subjects: direct‐acting antivirals -- hepatitis C -- β‐thalassaemia major -- cirrhosis -- treatment; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; 616.15
• DOI: 10.1111/bjh.14640
• Languages: English
• ISSNs: 0007-1048

Abstract

Summary: Interferon‐based regimens for chronic hepatitis C (CHC) were often deferred in patients with β‐thalasaemia major (β‐TM) due to poor efficacy and tolerance. Current guidelines recommend direct‐acting antivirals (DAAs) for these patients. The aim of this study was to assess the safety and efficacy of DAAs in patients with β‐TM and advanced liver disease due to CHC. Patients were recruited from eight liver units in Greece. The stage of liver disease was assessed using transient elastography and/or liver histology. Five regimens were used: sofosbuvir (SOF) + ribavirin (RBV); SOF + simeprevir ± RBV; SOF + daclatasvir ± RBV; ledipasvir/SOF ± RBV and ombitasvir/paritaprevir‐ritonavir + dasabuvir ± RBV. Sixty‐one patients (median age 43 years) were included. The majority of patients was previously treated for hepatitis C (75%) and had cirrhosis (79%). Viral genotype distribution was: G1a: n = 10 (16%); G1b: n = 22 (36%); G2: n = 2 (3%); G3: n = 14 (23%); G4: n = 13 (22%). The predominant chelation therapy was a combination of deferoxamine and deferiprone (35%). Overall sustained virological response rates were 90%. All treatment regimens were well tolerated and no major adverse events or drug‐drug interactions were observed. Approximately half of the patients who received RBV (7/16, 44%) had increased needs for blood transfusion. Treatment of CHC with DAAs in patients with β‐TM and advanced liver disease was highly effective and safe.