Response to Interferon Alfa-2b Therapy in Multitransfused Children with Beta-thalassemia and Chronic Hepatitis C

 Hepatitis C virus is responsible for the majority of cases of post-transfusion non-A non-B hepatitis in patients with thalassemia major. Interferon alfa is an effective treatment for patients with chronic hepatitis C. Response to therapy is related to the duration of treatment, the viral load in serum, and the hepatitis C virus genotype. The purpose of this study was to estimate the response of multitransfused children with β-thalassemia and chronic hepatitis C to interferon alfa-2b therapy. Thirteen patients with β-thalassemia and chronic hepatitis C, (mean age±SD, 14.1±1.7 years) participated in the study. Liver biopsy, estimation of HCV RNA, and virus genotyping were performed before onset of treatment. All patients were positive for HCV RNA in a low concentration; two patients carried the 1a genotype, four had genotype 3, and seven had genotype 4. Patients were treated with 3×106 U of subcutaneous interferon alfa-2b three times weekly. Eleven of 13 patients received therapy for 18 months; the remaining two underwent therapy for 6 months. Six of 13 patients responded completely to therapy, four responded partially, and three did not respond at all. The grade of inflammation and stage of fibrosis was lower in complete responders. Complete responders had lower ferritin values compared with the values for partial and nonresponders before starting therapy. The results suggest that interferon therapy should be recommended for children with β-thalassemia major complicated by a low viral concentration of hepatitis C.