LONG-TERM EFFICACY OF ALPHA-INTERFERON IN BETA-THALASSEMICS WITH CHRONIC HEPATITIS-C

Hepatitis C virus (HCV) infection is a common cause of liver disease a mong polytransfused thalassemics. We treated a cohort of subjects with beta-thalassemia major and chronic hepatitis C with alpha-interferon. The aims of the study were to assess the long-term biochemical and vi rologic efficacy of alpha-interferon and to evaluate the influence of HCV type and liver siderosis on the outcome of therapy. Seventy subjec ts (mean age, 14.1 years) with chronic HCV infection and abnormal amin otransferases received recombinant alpha-interferon for 12 months and were observed after therapy for at least 24 months. Sixty-three subjec ts (90%) were HCV-RNA positive at the start of therapy. HCV type 1b wa s found in 41 subjects (65.1%), non-1b types in 13 (20.6%), and mixed HCV types in 9 (14.33%). Liver biopsy showed cirrhosis in 11 subjects (15.7%) and siderosis grade 3-4 in 24 patients (34.2%). Three patients stopped therapy due to adverse events. Twenty-eight subjects (40%) ha d normal aminotransferases and had cleared HCV-RNA when last observed (mean follow-up, 36.5 months; range, 25 to 49 months). Of 41 patients who did not normalize aminotransferases, 9 had become HCV-RNA negative at the end of follow-up, The absence of cirrhosis, low liver iron con tent, and infection with non-lb HCV type were independently associated to complete sustained response upon multivariable analysis. In conclu sion, alpha-interferon may induce a sustained virologic and biochemica l remission of hepatitis in beta-thalassemic patients with chronic HCV infection and nonadvanced liver disease. (C) 1997 by The American Soc iety of Hematology.