Treatment of hepatitis C virus infection with direct‐acting antiviral drugs is safe and effective in patients with hemoglobinopathies |
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| Authors: | Raffaella Origa Maria Laura Ponti Aldo Filosa Alfonso Galeota Lanza Antonio Piga Giorgio Maria Saracco Valeria Pinto Antonino Picciotto Paolo Rigano Salvatore Madonia Rosamaria Rosso Domenico D'Ascola Maria Domenica Cappellini Roberta D'Ambrosio Immacolata Tartaglione Lucia De Franceschi Barbara Gianesin Vito Di Marco Gian Luca Forni Italy for THAlassemia and hepatitis C Advance ‐ Società Italiana Talassemie ed Emoglobinopatie |
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| Institution: | 1. University of Cagliari, Ospedale Pediatrico Microcitemico “A. Cao”, Cagliari, Italy;2. Medicina 1, AO Brotzu, Cagliari, Italy;3. Cardarelli Hospital, Naples, Italy;4. University of Turin, Turin, Italy;5. Centro della Microcitemia e delle Anemie Congenite, Galliera Hospital, Genoa, Italy;6. DIMI, University of Genoa, Genoa, Italy;7. Villa Sofia‐Cervello Hospital, Palermo, Italy;8. Ferrarotto Hospital, Policlinico Vittorio Emanuele, Catania, Italy;9. Centro Microcitemia, Reggio Calabria, Italy;10. University of Milan, Ca Granda Foundation IRCCS, Milan, Italy;11. University of Campania “Luigi Vanvitelli”, Naples, Italy;12. University of Verona, Verona, Italy;13. University of Palermo, Italy |
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| Abstract: | Progression of liver fibrosis in patients with hemoglobinopathies is strongly related to the severity of iron overload and the presence of chronic hepatitis C virus (HCV) infection. Effective iron chelation therapy and HCV infection eradication may prevent liver complications. The European Association for the Study of the Liver guidelines recommend interferon‐free regimens for the treatment of HCV infection in patients with hemoglobinopathies. However, data regarding the use of direct‐acting antiviral drugs (DAAs) in this patient population are few. This observational study evaluated the safety and efficacy of therapy with DAAs in an Italian cohort of patients with hemoglobinopathies, chronic HCV infection and advanced liver fibrosis. Between March 2015 and December 2016, 139 patients received DAAs and completed 12 weeks of follow up after the end of treatment for the evaluation of sustained virological response (12SVR). The 12SVR (93.5%) was comparable with that typically observed in cirrhotic patients without hemoglobinopathies. Three patients died during the period of observation of causes unrelated to DAAs. One patient did not achieve a virological response and five (3.6%) relapsed during 12 weeks of follow‐up after the end of therapy. In addition, patients showed significant reductions in serum ferritin at 12 weeks to levels similar to those observed in a control group of 39 patients with thalassemia major without HCV infection, who adhered to chelation therapy and had no overt iron overload. In conclusion, the use of DAAs appears to be safe and effective in patients with hemoglobinopathies and advanced liver disease due to HCV. |
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