Response to interferon alfa-2b therapy in multitransfused children with beta-thalassemia and chronic hepatitis C

Hepatitis C virus is responsible for the majority of cases of post-transfus ion non-A non-B hepatitis in patients with thalassemia major. Interferon al fa is an effective treatment for patients with chronic hepatitis C. Respons e to therapy is related to the duration of treatment, the viral load in ser um, and the hepatitis C virus genotype. The purpose of this study was to es timate the response of multitransfused children with beta-thalassemia and c hronic hepatitis C to interferon alfa-2b therapy. Thirteen patients with be ta-thalassemia and chronic hepatitis C, (mean age+/-SD, 14.1+/-1.7 years) p articipated in the study. Liver biopsy, estimation of HCV RNA, and virus ge notyping were performed before onset of treatment. All patients were positi ve for HCV RNA in a low concentration; two patients carried the la genotype , four had genotype 3, and seven had genotype 4. Patients were treated with 3 X 10(6) U of subcutaneous interferon alfa-2b three times weekly. Eleven of 13 patients received therapy for 18 months; the remaining two underwent therapy for 6 months. Six of 13 patients responded completely to therapy, f our responded partially, and three did not respond at all. The grade of inf lammation and stage of fibrosis was lower in complete responders. Complete responders had lower ferritin values compared with the values for partial a nd nonresponders before starting therapy. The results suggest that interfer on therapy should be recommended for children with beta-thalassemia major c omplicated by a low viral concentration of hepatitis C.