Sandoughdaran Saleh, Alavian Seyed Moayed, Sharafi Heidar, Behnava Bita, Salimi Shima, Mehrnoush Leila, Karimi Elizee Pegah, Keshvari Maryam
Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran ; Middle East Liver Diseases (MELD) Center, Tehran, IR Iran.
Hepat Mon. 2015 Jan 13;15(1):e23564. doi: 10.5812/hepatmon.23564. eCollection 2015 Jan.
Most thalassemic patients with chronic hepatitis C virus (HCV) infection do not respond to therapy with pegylated interferon (Peg-IFN) plus ribavirin (RBV) due to hepatic siderosis and RBV dose reduction caused by RBV-induced anemia.
In the present study, we recruited HCV genotype 1-infected thalassemic patients who had relapsed after a 48-week treatment with Peg-IFN plus RBV in order to evaluate the efficacy of a 72-week regimen of Peg-IFN plus RBV.
In this retrospective study, 23 thalassemic patients with HCV genotype 1 infection who had prior relapse after treatment with Peg-IFN and RBV for 48 weeks were consecutively enrolled in this study for evaluation of the efficacy of a 72-week treatment regimen.
For the 21 included cases, mean age was 29.7 years; 81% were men and 28.6% had cirrhosis. At the end of the treatment, nine (42.9%) patients had an undetectable level of HCV RNA in their sera. However, six months after treatment completion four of these patients relapsed and a sustained virological response (SVR) was found in five (23.8%) patients. Undetectable HCV RNA level at week 4 (P = 0.03) and undetectable HCV RNA level at week 12 (P < 0.01) were found to be predictors of SVR. There was an average 47.9% increase in blood transfusion during therapy and treatment was discontinued for 12 (57.1%) patients prematurely.
The present study suggests that thalassemic patients with chronic hepatitis C genotype 1 infection who did not achieve SVR after a course of therapy with Peg-IFN and RBV may benefit from being retreated with a 72-week regimen.
大多数慢性丙型肝炎病毒（HCV）感染的地中海贫血患者由于肝铁沉积和利巴韦林（RBV）诱导的贫血导致RBV剂量减少，对聚乙二醇干扰素（Peg-IFN）联合RBV治疗无反应。
在本研究中，我们招募了在接受Peg-IFN联合RBV治疗48周后复发的HCV基因1型感染的地中海贫血患者，以评估Peg-IFN联合RBV 72周治疗方案的疗效。
在这项回顾性研究中，连续纳入23例先前接受Peg-IFN和RBV治疗48周后复发的HCV基因1型感染的地中海贫血患者，以评估72周治疗方案的疗效。
对于纳入的21例病例，平均年龄为29.7岁；81%为男性，28.6%有肝硬化。治疗结束时，9例（42.9%）患者血清中HCV RNA水平检测不到。然而，治疗完成6个月后，其中4例患者复发，5例（23.8%）患者获得持续病毒学应答（SVR）。第4周HCV RNA水平检测不到（P = 0.03）和第12周HCV RNA水平检测不到（P < 0.01）被发现是SVR的预测因素。治疗期间输血平均增加47.9%，12例（57.1%）患者提前终止治疗。
本研究表明，接受Peg-IFN和RBV一个疗程治疗后未获得SVR的慢性丙型肝炎基因1型感染的地中海贫血患者，再次接受72周治疗方案可能有益。
