title: Natural history of hepatitis C in thalassemia major: a long-term prospective study.
abstract: BACKGROUND
  Transfusion-acquired hepatitis C virus (HCV) remains an important problem among patients with thalassemia. In this study, we evaluated the natural history of post-transfusional hepatitis C in thalassemia major, paying special attention to spontaneous viral clearance, to factors influencing the chronicity rate and fibrosis progression.
  
  
  METHODS
  A prospective study to evaluate the incidence and etiology of transfusion-related hepatitis was started in 1980. In patients who developed hepatitis C, HCV RNA, ALT, and ferritin were measured over time. The correlation between interleukin-28B gene polymorphisms and viral clearance was also analyzed.
  
  
  RESULTS
  Seventy-three of 135 patients (62.2%) acquired HCV. An extended follow-up (22 to 30 yr) with HCV RNA assessment was available in 52 patients. Of them, 23 (44.2%) cleared the virus. The proportion of IL-28B genotypes was different between the subjects who cleared the virus and the subjects who did not. Fibrosis progression was similar in HCV RNA-positive and HCV RNA-negative patients. Liver iron was the only factor associated with the fibrosis.
  
  
  CONCLUSIONS
  In thalassemia patients with HCV infection, liver iron does not play a major role in influencing the chronicity rate, whereas it is significantly associated with the fibrosis.
authors: Ospedale Regionale per le Microcitemie, ASL8, Cagliari, Italy.
authors: Maria E
authors: ME
authors: Lai
authors: Raffaella
authors: R
authors: Origa
authors: Fabrice
authors: F
authors: Danjou
authors: Gian B
authors: GB
authors: Leoni
authors: Stefania
authors: S
authors: Vacquer
authors: Franco
authors: F
authors: Anni
authors: Claudia
authors: C
authors: Corrias
authors: Patrizia
authors: P
authors: Farci
authors: Giovanna
authors: G
authors: Congiu
authors: Renzo
authors: R
authors: Galanello
mesh_terms: D001803:Blood Transfusion; D017848:Blood-Borne Pathogens; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000235:genetics / Q000378:metabolism; D019698:Hepatitis C, Chronic / Q000097:blood / Q000235:genetics; D006801:Humans; D007223:Infant; D007372:Interferons; D007378:Interleukins / Q000097:blood / Q000235:genetics; D007501:Iron / Q000378:metabolism; D008099:Liver / Q000378:metabolism / Q000821:virology; D008297:Male; D011110:Polymorphism, Genetic; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood / Q000235:genetics; D012189:Retrospective Studies; D017086:beta-Thalassemia / Q000097:blood / Q000235:genetics / Q000821:virology; D000095022:Interferon Lambda
chemical_list: D007372:Interferons; D007378:Interleukins; D007501:Iron; D012367:RNA, Viral; C000624353:interferon-lambda, human; D000095022:Interferon Lambda