Management of chronic viral hepatitis in patients with thalassemia: recommendations from an international panel.
Chelation therapy with new drugs prevents cardiac damage and improves the survival of thalassemia patients. Liver diseases have emerged as a critical clinical issue. Chronic liver diseases play an important role in the prognosis of thalassemia patients because of the high frequency of viral infections and important role of the liver in regulating iron metabolism. Accurate assessment of liver iron overload is required to tailor iron chelation therapy. The diagnosis of hepatitis B virus- or hepatitis C virus-related chronic hepatitis is required to detect patients who have a high risk of developing liver complications and who may benefit by antiviral therapy. Moreover, clinical management of chronic liver disease in thalassemia patients is a team management issue requiring a multidisciplinary approach. The purposes of this paper are to summarize the knowledge on the epidemiology and the risks of transmission of viral infections, to analyze invasive and noninvasive methods for the diagnosis of chronic liver disease, to report the knowledge on clinical course of chronic viral hepatitis, and to suggest the management of antiviral therapy in thalassemia patients with chronic hepatitis B or C virus or cirrhosis.
Di Marco
Vito
V
Italian Society for the Study of Thalassemia and Haemoglobinopathies, Rome, Italy. vito.dimarco@tin.it
Capra
Marcello
M
Angelucci
Emanuele
E
Borgna-Pignatti
Caterina
C
Telfer
Paul
P
Harmatz
Paul
P
Kattamis
Antonis
A
Prossamariti
Luciano
L
Filosa
Aldo
A
Rund
Deborah
D
Gamberini
Maria Rita
MR
Cianciulli
Paolo
P
De Montalembert
Marianne
M
Gagliardotto
Francesco
F
Foster
Graham
G
Grangè
Jean Didier
JD
Cassarà
Filippo
F
Iacono
Angela
A
Cappellini
Maria Domenica
MD
Brittenham
Gary M
GM
Prati
Daniele
D
Pietrangelo
Antonello
A
Craxì
Antonio
A
Maggio
Aurelio
A
D000998:Antiviral Agents / Q000627:therapeutic use*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000635:transmission; D019698:Hepatitis C, Chronic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000635:transmission; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis; D013789:Thalassemia / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology
D000998:Antiviral Agents