Effect of iron overload on the response to recombinant interferon-alfa treatment in transfusion-dependent patients with thalassemia major and chronic hepatitis C.
The purpose of this study was to determine whether interferon-alfa (IFN-alpha) therapy benefits patients with transfusion-dependent thalassemia and chronic active hepatitis C, and whether their iron burden modifies the response to this therapy. We conducted a controlled trial of recombinant IFN-alpha (3 million units per square meter of body surface area, three times a week for 15 months) in 65 patients with thalassaemia major and chronic active hepatitis C; 14 of them were untreated control subjects. In 21 of the 51 treated patients, alanine aminotransferase values returned to normal within 6 months, and hepatitis C virus ribonucleic acid was no longer detected in serum; no changes were detected among control subjects. The response to IFN-alpha therapy was inversely related (p < 0.002) to the liver iron burden as assessed by atomic absorption, the histologic semiquantitative method, or both methods. During 3 years of follow-up, two responder patients had relapses. We conclude that IFN-alpha represents a useful therapeutic option for children with transfusion-dependent thalassemia and chronic active hepatitis C with a mild to moderate iron burden.
Clemente
M G
MG
Istituto di Clinica e Biologia dell'Età Evolutiva, Università degli Studi, Cagliari, Italy.
Congia
M
M
Lai
M E
ME
Lilliu
F
F
Lampis
R
R
Frau
F
F
Frau
M R
MR
Faa
G
G
Diana
G
G
Dessì
C
C
D000293:Adolescent; D000328:Adult; D002648:Child; D005293:Ferritins / Q000097:blood; D006432:Hemochromatosis / Q000209:etiology / Q000503:physiopathology*; D006526:Hepatitis C / Q000209:etiology / Q000628:therapy*; D006521:Hepatitis, Chronic / Q000209:etiology / Q000628:therapy*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D007501:Iron / Q000032:analysis; D008099:Liver / Q000737:chemistry; D065227:Transfusion Reaction; D016896:Treatment Outcome; D017086:beta-Thalassemia / Q000097:blood / Q000150:complications / Q000628:therapy*
D016898:Interferon-alpha; D005293:Ferritins; D007501:Iron