Safety of pegylated interferon and ribavirin therapy for chronic hepatitis C in patients with sickle cell anemia

Author(s): Issa H

Abstract

Aim: To evaluate the safety and efficacy of combined pegylated interferon and ribavirin for the treatment of chronic hepatitis C (HCV) in patients with sickle cell anemia (SCA).

Methods: Fifty-two patients with SCA and HCV were treated over a period of 7 years from June 2002 to July 2009. Their medical records were reviewed for: age at treatment, sex, body mass index, Hb level at the start of therapy and on follow-up, hemoglobin electrophoresis, liver function tests, G6PD level, LDH, bilirubin, HCV-RNA viral load, HCV genotype, liver biopsy, duration of treatment, and side effects. All were treated with pegylated interferon and a standard dose of ribavirin. The treatment was continued for 24 wk for those with genotype 2 and 3 and for 48 wk for those with genotype 1 and 4.

Results: Fifty-two patients (30 females and 22 males) were treated. Their mean age was 29.5 years (range 15-54 years). HCV genotype was determined in 48 and 15 had liver biopsy. Their mean pre-treatment HCV-RNA viral load was 986330 IU/mL (range 12762-3329282 IU/mL). The liver biopsy showed grade I in 6 and grade II in 9 and stage I in 13 and stage II in 2. Only 8 were receiving hydroxyurea at the time of treatment. All tolerated the treatment well and none experienced a decrease in their Hb which required blood transfusion pre, during or after therapy. There were no hematological side effects attributable to ribavirin at the usual recommended dose. Thirty-seven (71.2%) achieved SVR at 6 mo after the end of treatment. The remaining 15 were non-responders. Two of them showed an ETR but had a relapse. The remaining 13 had a relatively significant HCV-RNA viral load with a mean HCV-RNA viral load of 1829741.2 IU/mL (900000-3329282 IU/mL) and eight of them had HCV genotype 1, four had HCV genotype 4, and one had HCV genotype 5.

Conclusion: Patients with SCA and HCV can be treated with pegylated interferon and ribavirin at the usual recommended dose. This is even so in those who are not receiving hydroxyurea. The treatment is safe and effective and the response rate is comparable to those without SCA.

Similar Articles

Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome

Author(s): Choo QL, Kuo G, Weiner AJ, Overby LR, Bradley DW, et al.

Global burden of disease (GBD) for hepatitis C

Author(s): Global Burden Of Hepatitis C Working Group

The hepatitis C virus life cycle as a target for new antiviral therapies

Author(s): Pawlotsky JM, Chevaliez S, McHutchison JG

Global distribution and prevalence of hepatitis C virus genotypes

Author(s): Messina JP, Humphreys I, Flaxman A, Brown A, Cooke GS, et al.

HCV genotypes among 1013 Saudi nationals: a multicenter study

Author(s): Al Traif I, Al Balwi MA, Abdulkarim I, Handoo FA, Alqhamdi HS, et al.

Genetic epidemiology of hepatitis C virus throughout egypt

Author(s): Ray SC, Arthur RR, Carella A, Bukh J, Thomas DL

Telaprevir activity in treatment-naive patients infected hepatitis C virus genotype 4: a randomized trial

Author(s): Benhamou Y, Moussalli J, Ratziu V, Lebray P, De Backer K, et al.

Socioeconomic status in HCV infected patients - risk and prognosis

Author(s): Omland LH, Osler M, Jepsen P, Krarup H, Weis N, et al.

Peginterferon alfa-2b plus ribavirin for the treatment of chronic hepatitis C genotype 4

Author(s): Hasan F, Asker H, Al-Khaldi J, Siddique I, Al-Ajmi M, et al.

Response to pegylated interferon alfa-2a and ribavirin in chronic hepatitis C genotype 4

Author(s): El Makhzangy H, Esmat G, Said M, Elraziky M, Shouman S, et al.

Response to pegylated interferon plus ribavirin in HIV-infected patients with chronic hepatitis C due to genotype 4

Author(s): Martín-Carbonero L, Puoti M, García-Samaniego J, De Luca A, Losada E, et al.

Sofosbuvir for previously untreated chronic hepatitis C infection

Author(s): Lawitz E, Mangia A Wyles D, Rodriguez-Torres M, Hassanein T, et al.

Efficacy and safety of sofosbuvir-based triple therapy in hepatitis C genotype 4 infection

Author(s): Wehmeyer MH, Jordan S, Lüth S, Hartl J, Stoehr A, et al.

Daclatasvir plus peginterferonalfa and ribavirin for treatment-naive chronic hepatitis C genotype 1 or 4 infection: a randomised study

Author(s): Hézode C, Hirschfield GM, Ghesquiere W, Sievert W, Rodriguez-Torres M, et al.

Daclatasvir and asunaprevir plus peginterferonalfa and ribavirin in HCV genotype 1 or 4 non-responders

Author(s): Jensen D, Sherman KE, Hézode C, Pol S, Zeuzem S, et al.

Hepatitis C virus treatment in the real world: optimising treatment and access to therapies

Author(s): Zoulim F, Liang TJ, Gerbes AL Aghemo A4, Deuffic-Burban S5, et al.

Sofosbuvir plus ribavirin for treating Egyptian patients with hepatitis C genotype 4

Author(s): Doss W, Shiha G, Hassany M, Soliman R, Fouad R, et al.

Daclatasvir plus sofosbuvir for previously treated or untreated chronic HCV infection

Author(s): Sulkowski MS, Gardiner DF, Rodriguez-Torres M, Reddy KR, Hassanein T, et al.

Ledipasvir and sofosbuvir for untreated HCV genotype 1 infection

Author(s): Afdhal N, Zeuzem S, Kwo P, Chojkier M, Gitlin N, et al.