Annals of Hematology

, Volume 92, Issue 6, pp 739–746

Hepatitis C in patients with β-thalassemia major. A single-centre experience

  • Christos Triantos
  • Alexandra Kourakli
  • Maria Kalafateli
  • Dimitra Giannakopoulou
  • Nikolaos Koukias
  • Konstantinos Thomopoulos
  • Polixeni Lampropoulou
  • Christina Bartzavali
  • Helen Fragopanagou
  • George C. Kagadis
  • Mirto Christofidou
  • Athanasios Tsamandas
  • Vasiliki Nikolopoulou
  • Marina Karakantza
  • Chryssoula Labropoulou-Karatza
Original Article

DOI: 10.1007/s00277-013-1692-6

Cite this article as:
Triantos, C., Kourakli, A., Kalafateli, M. et al. Ann Hematol (2013) 92: 739. doi:10.1007/s00277-013-1692-6

Abstract

Chronic hepatitis C (CHC) and iron overload are the main causes of liver disease in β-thalassemia major (βTM). There is limited data regarding the course of CHC in this population. All patients (n = 144) from the thalassemia centre of the University Hospital of Patras were evaluated (January 1981 to June 2012). Patients were classified into group A (n = 57), which consisted of patients with CHC, who either had received antiviral treatment (n = 49) or not (n = 8), and group B which included 87 patients without CHC. Nineteen patients died during follow-up (median: 257.5 months (1–355)). Survival rates were 84.2 % and 88.5 % for group A and B, respectively. The causes of death were heart failure (63.2 %), accident (10.5 %), sepsis (5.3 %), liver failure (5.3 %), hepatocellular carcinoma (HCC) (5.3 %), non-Hodgkin lymphoma (5.3 %) and multiorgan failure (5.3 %). There were no differences in total survival between the two groups (p = 0.524). In the multivariate analysis, survival was neither correlated with CHC (p = ns), nor with anti-HCV treatment (p = ns), whereas independent negative predictors were presence of heart failure (p < 0.001), presence of malignancy other than HCC (p = 0.001) and non-adherence to chelation treatment (p = 0.013). Predictive factors for the development of cirrhosis were: CHC (p < 0.001), age > 35 years (p = 0.007), siderosis grade 3/4 (p = 0.029) and splenectomy (p = 0.001); however, multivariately, only siderosis grade 3/4 was found to be significant (p = 0.049). In this study, survival of patients with βTM was mainly associated with heart failure, presence of malignancy other than HCC and non-adherence to chelation treatment, rather than with liver disease. Multicentre studies need to be designed to define more accurately the indications of antiviral treatment in this population.

Keywords

Thalassemia majorHepatitis CLiver fibrosisInterferon-alphaRibavirin

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Christos Triantos
    • 1
  • Alexandra Kourakli
    • 2
  • Maria Kalafateli
    • 1
  • Dimitra Giannakopoulou
    • 1
  • Nikolaos Koukias
    • 1
  • Konstantinos Thomopoulos
    • 1
  • Polixeni Lampropoulou
    • 2
  • Christina Bartzavali
    • 3
  • Helen Fragopanagou
    • 2
  • George C. Kagadis
    • 4
  • Mirto Christofidou
    • 3
  • Athanasios Tsamandas
    • 5
  • Vasiliki Nikolopoulou
    • 1
  • Marina Karakantza
    • 2
  • Chryssoula Labropoulou-Karatza
    • 6
  1. 1.Department of GastroenterologyUniversity Hospital of PatrasPatrasGreece
  2. 2.Department of HematologyUniversity Hospital of PatrasPatrasGreece
  3. 3.Department of MicrobiologyUniversity Hospital of PatrasPatrasGreece
  4. 4.Department of Medical Physics, School of MedicineUniversity of PatrasPatrasGreece
  5. 5.Department of PathologyUniversity Hospital of PatrasPatrasGreece
  6. 6.Department of Internal MedicineUniversity Hospital of PatrasPatrasGreece