Treatment of chronic hepatitis C with direct-acting antivirals in patients with [beta]-thalassaemia major and advanced liver disease

Summary Interferon-based regimens for chronic hepatitis C (CHC) were often deferred in patients with [beta]-thalasaemia major ([beta]-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 safet...

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Bibliographic Details
Published in:British journal of haematology 2017-07, Vol.178 (1), p.130
Main 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
Format: Article
Language:English
Subjects:
Antiviral agents
Blood diseases
Blood transfusion
Chelation
Cirrhosis
Deferoxamine
Hematology
Hepatitis
Hepatitis C
Histology
Interferon
Liver
Liver cirrhosis
Liver diseases
Patients
Ribavirin
Ritonavir
Transfusion
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Summary:Summary Interferon-based regimens for chronic hepatitis C (CHC) were often deferred in patients with [beta]-thalasaemia major ([beta]-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 [beta]-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 [beta]-TM and advanced liver disease was highly effective and safe.
ISSN:0007-1048
1365-2141
DOI:10.1111/bjh.14640