Antiviral Treatment of Chronic Hepatitis C Infection among Children and Adolescents with Beta‑Thalassemia Major

Abstract

Background: Hepatitis C virus (HCV) was encountered as one of the most common infections transmitted through blood transfusion tothalassemic patients. After the discovery of new generations of antiviral drugs labeled direct‑acting antiviral (DAA) drug since 2014, promisingresults were reported compared to older regimen of Peginterferon with or without ribavirin (RBV). Objective: The main objective of the studyis to assess the hepatitis C viral status of multitransfused beta‑thalassemia major patients and the sustained viral response rate to differentmodalities of therapy. Materials and Methods: A cross‑sectional analytical study was conducted in Erbil Thalassemia Center. A sample ofall children and adolescent (18 years or younger) patients of beta‑thalassemia major with HCV antibody positive were reviewed according tothe available medical records in the center. They were divided into two groups (first who received interferon ([IFN] ± RBV and second whoreceived sofosbuvir (SOF) and daclatasvir [DCV]) for the aim of the study. Results: Among registered 695 patients with thalassemia majorscreened for HCV antibody, 659 children and adolescents were included and 186 were tested seropositive (28.22%), and they had been submittedto polymerase chain reaction analysis with HCV‑RNA identified in 110 (59.13% of initially ELISA test positive). IFN‑dependent therapy wasgiven to 87 patients, while sofosbuvir and DCV for remaining 21 patients, sustained viral response was 100% among those received lattertherapy with no reported relapse compared to former regimen of 44.3% sustained response and 6.33% relapse rate. Conclusion: DAA drug hasa promising therapeutic result replacing the old therapy of IFN‑RBV among thalassemic patients with 100% response rate in the study group.