Safety and Efficacy of Direct-Acting Antivirals in Transfusion-Dependent Thalassemic Patients with Chronic Hepatitis C

AuthorSimona Onalien
AuthorIvana Maidaen
AuthorCinzia Balestrierien
AuthorFrancesco Arcaduen
AuthorEnrico Urruen
AuthorDavide Porcuen
AuthorGiancarlo Serraen
AuthorGiacomo Floreen
AuthorElena Doreen
AuthorCaterina Sattaen
AuthorPier Paolo Bittien
AuthorMaria Grazia Sannaen
AuthorLoredana Serusien
AuthorMichele Casaleen
AuthorMaria Contien
AuthorMartina Loien
AuthorFrancesco Figorillien
AuthorMaria Cristina Pasettoen
AuthorSergio Babudierien
AuthorLuchino Chessaen
Issued Date2018-01-31en
AbstractBackground: Hepatitis C virus (HCV) infection is a major cause of liver-related morbidity and mortality among thalassemic patients. New treatments based on direct-acting antivirals (DAAs) are highly effective and well-tolerated by patients; nonetheless, they have not been studied in thalassemic populations. In this study, we evaluated the safety and efficacy of these treatments in a cohort of Sardinian thalassemic patients with chronic HCV infection. Methods: We consecutively recruited thalassemic patients with HCV infection, who were eligible for DAA therapy at 3 liver units. Different drug combinations, depending on HCV genotype and hepatic disease severity, were used according to the current guidelines. Sustained virological response was assessed at 12 weeks posttreatment. Data regarding the side effects and transfusion requirements were also collected. Results: We recruited 49 patients, including 29 males (59.2%), with the mean age of 43 years (genotype 1, 55.1%). Twenty-one (42.9%) patients had a history of interferon-based treatment. Cirrhosis was detected in 28 (57.1%) patients; only 1 patient had ascites and hypoalbuminemia (Child-Pugh B7). On the other hand, 35 (71.4%) patients received a sofosbuvir-based regimen. Ribavirin treatment was reported in 26 (53.1%) cases. All the patients were followed-up for at least 12 weeks after therapy, and sustained virological response was observed in 98% of the patients. No treatment discontinuation was required due to adverse events. The most common side effects included fatigue (24.5%), headache (10.2%), and anaemia (77%), requiring further blood transfusion in patients receiving ribavirin. Conclusions: This prospective study showed that DAAs are safe and effective agents in thalassemic patients with advanced liver fibrosis, regardless of previous antiviral treatment responses.en
DOIhttps://doi.org/10.5812/hepatmon.61453en
KeywordThalassemiaen
KeywordHCVen
KeywordDAAsen
KeywordBlood Transfusionen
PublisherBrieflandsen
TitleSafety and Efficacy of Direct-Acting Antivirals in Transfusion-Dependent Thalassemic Patients with Chronic Hepatitis Cen
TypeResearch Articleen

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