title: Management of chronic viral hepatitis in patients with thalassemia: recommendations from an international panel.
abstract: 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.
authors.affiliation: Italian Society for the Study of Thalassemia and Haemoglobinopathies, Rome, Italy. vito.dimarco@tin.it
authors.forename: Vito
authors.initials: V
authors.lastname: Di Marco
authors.forename: Marcello
authors.initials: M
authors.lastname: Capra
authors.forename: Emanuele
authors.initials: E
authors.lastname: Angelucci
authors.forename: Caterina
authors.initials: C
authors.lastname: Borgna-Pignatti
authors.forename: Paul
authors.initials: P
authors.lastname: Telfer
authors.forename: Paul
authors.initials: P
authors.lastname: Harmatz
authors.forename: Antonis
authors.initials: A
authors.lastname: Kattamis
authors.forename: Luciano
authors.initials: L
authors.lastname: Prossamariti
authors.forename: Aldo
authors.initials: A
authors.lastname: Filosa
authors.forename: Deborah
authors.initials: D
authors.lastname: Rund
authors.forename: Maria Rita
authors.initials: MR
authors.lastname: Gamberini
authors.forename: Paolo
authors.initials: P
authors.lastname: Cianciulli
authors.forename: Marianne
authors.initials: M
authors.lastname: De Montalembert
authors.forename: Francesco
authors.initials: F
authors.lastname: Gagliardotto
authors.forename: Graham
authors.initials: G
authors.lastname: Foster
authors.forename: Jean Didier
authors.initials: JD
authors.lastname: Grangè
authors.forename: Filippo
authors.initials: F
authors.lastname: Cassarà
authors.forename: Angela
authors.initials: A
authors.lastname: Iacono
authors.forename: Maria Domenica
authors.initials: MD
authors.lastname: Cappellini
authors.forename: Gary M
authors.initials: GM
authors.lastname: Brittenham
authors.forename: Daniele
authors.initials: D
authors.lastname: Prati
authors.forename: Antonello
authors.initials: A
authors.lastname: Pietrangelo
authors.forename: Antonio
authors.initials: A
authors.lastname: Craxì
authors.forename: Aurelio
authors.initials: A
authors.lastname: Maggio
mesh_terms: 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
chemical_list: D000998:Antiviral Agents