Natural history of hepatitis C in thalassemia major: a long-term prospective study

Eur J Haematol. 2013 Jun;90(6):501-7. doi: 10.1111/ejh.12086. Epub 2013 Mar 14.

Abstract

Background: Transfusion-acquired hepatitis C virus (HCV) remains an important problem among patients with thalassemia. In this study, we evaluated the natural history of post-transfusional hepatitis C in thalassemia major, paying special attention to spontaneous viral clearance, to factors influencing the chronicity rate and fibrosis progression.

Design and methods: A prospective study to evaluate the incidence and etiology of transfusion-related hepatitis was started in 1980. In patients who developed hepatitis C, HCV RNA, ALT, and ferritin were measured over time. The correlation between interleukin-28B gene polymorphisms and viral clearance was also analyzed.

Results: Seventy-three of 135 patients (62.2%) acquired HCV. An extended follow-up (22 to 30 yr) with HCV RNA assessment was available in 52 patients. Of them, 23 (44.2%) cleared the virus. The proportion of IL-28B genotypes was different between the subjects who cleared the virus and the subjects who did not. Fibrosis progression was similar in HCV RNA-positive and HCV RNA-negative patients. Liver iron was the only factor associated with the fibrosis.

Conclusions: In thalassemia patients with HCV infection, liver iron does not play a major role in influencing the chronicity rate, whereas it is significantly associated with the fibrosis.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Transfusion*
  • Blood-Borne Pathogens*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Hepacivirus* / genetics
  • Hepacivirus* / metabolism
  • Hepatitis C, Chronic* / blood
  • Hepatitis C, Chronic* / genetics
  • Humans
  • Infant
  • Interferons
  • Interleukins* / blood
  • Interleukins* / genetics
  • Iron / metabolism
  • Liver / metabolism
  • Liver / virology
  • Male
  • Polymorphism, Genetic*
  • Prospective Studies
  • RNA, Viral* / blood
  • RNA, Viral* / genetics
  • Retrospective Studies
  • beta-Thalassemia* / blood
  • beta-Thalassemia* / genetics
  • beta-Thalassemia* / virology

Substances

  • interferon-lambda, human
  • Interleukins
  • RNA, Viral
  • Interferons
  • Iron