Clinical, Biochemical and Histopathological outcome of six months of Interferon therapy in thalassemic patients with chronic hepatitis C viral infection

Abstract

background: Hepatitis C viral infection is a common cause of liver disease among polytransfusedpatients.Aim of the study: To find out short term efficacy of Interferon therapy in thalassemic chronic viralhepatitis-C patients.Setting: This study was carried out in Gastroenterology and Hepatology Teaching hospital in Baghdad –IraqPatients and methods:Twenty four thalassemic patients who were anti HCV antibody positive withelevated liver enzyme for more than one year enrolled in this study . All patients were submitted to liverbiopsy to assess the degree of the inflammation and fibrosis .All patients were treated with interferonalpha (3 ×106 units/m2) tree times a week for six months.Result: Three out of twenty four patients stopped treatments because of sever side effect. Out of twentyone patients; 10(47 %) of patients showed complete biochemical response, 7(33%) of patients showedpartial biochemical response, 4(19%) of patients showed no response.Young age patients responded better to interferon therapy .patients with initial high serum alaninetrasaminase responded less favorably than those who had lower initial pretreatment serum alaninetransaminase ,this was statistically significant .The higher the initial serum ferritine the worst thebiochemical and histological response .All patients who responded biochemically and submitted toanother liver biopsy showed decrease in severity of histological activity index after six months ofInterferon therapy ;there was strong correlation between biochemical response and histological response.There was no improvement in degree of fibrosis in those treated with interferon therapy.Splenectomizedpatient tolerated better and responded better than those who were not splenectomized .Conclution:Thalassemic patients with chronic viral hepatitis C can benefit at least in short term fromInterferon therapy especially in younger age patients and those who have lowest elevation of liverenzymes and those with lower serum ferritin level.Keywords:Hepatitis,Hepatitis C,Thalassemia,Thalassemic patients ,Interferon