Hepatitis C in patients with β-thalassemia major. A single-centre experience
| Autor: | Chryssoula Labropoulou-Karatza, Polixeni Lampropoulou, Alexandra Kourakli, Vasiliki Nikolopoulou, Konstantinos Thomopoulos, Athanasios Tsamandas, Nikolaos Koukias, Helen Fragopanagou, Dimitra Giannakopoulou, Christos Triantos, Christina Bartzavali, Marina Karakantza, Maria Kalafateli, Mirto Christofidou, George C. Kagadis |
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| Rok vydání: | 2013 |
| Předmět: |
Liver Cirrhosis
Male Cirrhosis Thalassemia Comorbidity Kaplan-Meier Estimate Gastroenterology Liver disease Risk Factors Cause of Death Child education.field_of_study Greece Liver Neoplasms Hematology General Medicine Hepatitis C Middle Aged Liver Child Preschool Hepatocellular carcinoma Splenectomy Female Siderosis Adult medicine.medical_specialty Carcinoma Hepatocellular Iron Overload Adolescent Population Iron Chelating Agents Antiviral Agents Medication Adherence Young Adult Internal medicine medicine Humans education Proportional Hazards Models Retrospective Studies business.industry beta-Thalassemia Infant Transfusion Reaction Hepatitis C Chronic medicine.disease Chelation Therapy Surgery Heart failure business |
| Zdroj: | Annals of Hematology. 92:739-746 |
| ISSN: | 1432-0584 0939-5555 |
| DOI: | 10.1007/s00277-013-1692-6 |
| Popis: | 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 (p0.001), 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 (p0.001), age35 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. |
| Databáze: | OpenAIRE |
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