title: Efficacy of Interferon A-2b monotherapy in Β-thalassemics with chronic hepatitis C.
abstract: OBJECTIVE
  Monotherapy with standard or pegylated interferon (PegIFN) remains the first-line treatment for HCV infection in patients with thalassemia major (βTM), although its long-term impact is still unknown. We aimed to assess the efficacy of IFN-a2b/PegIFN-a2b (one or multiple treatment sessions) and the predictors for sustained virological response (SVR) in HCV-infected βTM patients.
  
  
  METHODS
  Between 11/1992 and 12/2013 [median follow-up: 165.5 months (8-237)], 48 βTM HCV-infected patients [19 males, median age: 22 years (12-45)], received IFN-a2b (n=34) or PegIFN-a2b (n=14). Twenty-three patients (47.9%) had a previous splenectomy; 13/40 (32.5%) patients had Ishak stage >/=4 and 21/40 (52.5%) had siderosis grade 3-4. HCV-genotype was available in 36 patients (genotype 1: 47.2%, 2: 5.6%, 3: 25%, and 4: 22%). IL28B genotype was determined in 37 patients by means of in-house real-time PCR (CC: 27%, CT: 62.2%, TT: 10.8%).
  
  
  RESULTS
  Totally, 15/48 (31.3%) achieved SVR following the first treatment and 18/48 (37.5%) after multiple courses. Splenectomy (p=0.01) and fibrosis grade >/=4 (p<0.05) were negative predictors for SVR (first course), whereas splenectomy (p<0.05) and age >18 (p<0.02) for SVR after multiple courses. In HCV-genotype 1/4 (n=25), none of the patients with CT or TT IL28B genotype achieved SVR compared to 50% of the CC patients (p=0.004).
  
  
  CONCLUSIONS
  Interferon is an effective therapeutic option in HCV-infected βTM patients. IL28B genotype was a strong predictor for SVR, together with splenectomy, age and fibrosis.
authors.affiliation: Department of Gastroenterology, Patras, Greece. mariakalaf@hotmail.com.
authors.forename: Maria
authors.initials: M
authors.lastname: Kalafateli
authors.affiliation: Department of Internal Medicine, Hematology Division / Thalassemia and Hemoglobinopathies Unit, University Hospital of Patras, Patras; Greece.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kourakli
authors.affiliation: Department of Medicine and Research Laboratory of Internal Medicine, Medical School, University of Thessaly, Larissa; Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Gatselis
authors.affiliation: Department of Internal Medicine, Hematology Division / Thalassemia and Hemoglobinopathies Unit, University Hospital of Patras, Patras; Greece.
authors.forename: Polixeni
authors.initials: P
authors.lastname: Lambropoulou
authors.affiliation: Department of Gastroenterology; Patras, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Thomopoulos
authors.affiliation: Department of Pathology, Patras, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Tsamandas
authors.affiliation: Department of Microbiology, Patras, Greece.
authors.forename: Mirto
authors.initials: M
authors.lastname: Christofidou
authors.affiliation: Department of Medicine and Research Laboratory of Internal Medicine, Medical School, University of Thessaly, Larissa; Greece.
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Zachou
authors.affiliation: Department of Public Health, School of Medicine, Patras, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Jelastopoulou
authors.affiliation: Department of Digestive Oncology, Gustave Roussy Institute of Oncology, Villejuif; Department of Pathology, CHU Rouen, France.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Nikolopoulou
authors.affiliation: Department of Internal Medicine, Hematology Division / Thalassemia and Hemoglobinopathies Unit, University Hospital of Patras, Patras;
authors.forename: Argiris
authors.initials: A
authors.lastname: Symeonidis
authors.affiliation: Department of Medicine and Research Laboratory of Internal Medicine, Medical School, University of Thessaly, Larissa; Greece.
authors.forename: George N
authors.initials: GN
authors.lastname: Dalekos
authors.affiliation: Department of Internal Medicine, University Hospital of Patras, Patras, Greece.
authors.forename: Chrissoula
authors.initials: C
authors.lastname: Lambropoulou-Karatza
authors.affiliation: Department of Gastroenterology; Patras, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Triantos
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D007372:Interferons; D007378:Interleukins / Q000235:genetics; D007502:Iron Chelating Agents / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000188:drug therapy / Q000821:virology; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D013156:Splenectomy; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult; D017086:beta-Thalassemia / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D000095022:Interferon Lambda
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D007372:Interferons; D007378:Interleukins; D007502:Iron Chelating Agents; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; C000624353:interferon-lambda, human; D000095022:Interferon Lambda; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a