Effect of hepatic iron concentration and viral factors in chronic hepatitis C-infected patients with thalassemia major, treated with interferon and ribavirin

Abstract

Background:

Beta thalassemia major patients are vulnerable to transfusion-transmitted infection, especially hepatitis C virus (HCV), and iron overload. These comorbidities lead to cirrhosis and hepatocellular carcinoma in these patients. In order to prevent these complications, treatment of HCV infection and regular iron chelating seems to be necessary. The aim of this study was to evaluate the effect of hepatic iron concentration (HIC) and viral factors on the sustained virological response (SVR) in chronic HCV-infected patients, with beta thalassemia major being treated with interferon and ribavirin.

Materials and methods:

We enrolled 30 patients with thalassemia major and chronic HCV who were referred to the Hematology Clinic of Guilan University of Medical Sciences, between December 2002 and April 2006. HIC was measured by atomic absorption spectroscopy before treatment. The viral factors (viral load, genotype) and HIC were compared between those who achieved a SVR and nonresponders.

Results:

Mean age of the 30 thalassemic patients, was 22.56 ± 4.28 years (14–30 years). Most patients were male (56.7%). Genotype 1a was seen in 24 (80%) cases. SVR was achieved in 15 patients (50%). There were no significant correlations between HIC (P = 1.00), viral load (P = 0.414), HCV genotype (P = 0.068), and SVR. No difference was observed in viral load (P = 0.669) and HIC (P = 0.654) between responders and nonresponders.

Conclusion:

HIC, HCV viral load, and HCV genotype were not correlated with virological response, and it seems that there is no need to postpone antiviral treatment for more vigorous iron chelating therapy.

Keywords:

• hepatitis C virus
• hepatic iron concentration
• combination therapy
• thalassemia major
• interferon alfa
• ribavirin

Acknowledgements

This study was supported by grants from Guilan University of Medical Sciences. The hepatic iron quantification was performed at the Pathology Ward of Cancer Institute of Tehran University of Medical Sciences and we are grateful to Dr Isa Jahanzad for their relevant contribution. We thank Dr Pantea Azarpira for performing liver biopsies. We also thank Dr Saba Hoda for interpretation of pathology specimens.

Disclosure

The authors declare no conflicts of interest.