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首页> 外文期刊>Journal of the Formosan Medical Association =: Taiwan yi zhi >The treatment outcome and impact on blood transfusion demand of Peg-interferon/ribavirin in thalassemic patients with chronic hepatitis C
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The treatment outcome and impact on blood transfusion demand of Peg-interferon/ribavirin in thalassemic patients with chronic hepatitis C

机译：聚乙二醇干扰素/利巴韦林对慢性丙型肝炎地中海贫血患者的治疗效果及对输血需求的影响

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Background/Aims Hepatitis C virus (HCV) prevails in patients with thalassemia. We aimed to investigate the efficacy, safety, and impact on red blood cells (RBC) transfusion demand of pegylated interferon (Peg-IFN)/ribavirin therapy in thalassemic patients with HCV. Methods This retrospective study included 18 thalassemic patients (16 with HCV-1b, one HCV-1b/2b, and one HCV-2b) and 54 consecutive sex- and genotype-matched controls. Patients with HCV-2, or HCV-1 or mixed HCV-1/2 with lower viral loads plus rapid virological response (RVR) received 24-week Peg-IFN/ribavirin; whereas HCV-1 or mixed HCV-1/2 with higher viral loads or without RVR received 48-week regimens. Results The rates of RVR, complete early virological response, and sustained virological response (SVR) in thalassemic patients were 72.2% (13/18), 94.1% (16/17), and 77.8% (14/18), which resembled those of controls (63.0%, 94.4%, and 81.5%, respectively). RVR was the only significant factor associated with SVR in thalassemic group, and was the strongest predictor for SVR among both groups (OR/95% CI?=?14.7/2.20–98.6), followed by male gender and lower viral loads. More proportion of interleukin-28B-TT carriage were observed among thalassemic patients with SVR versus non-SVR (78.6% vs. 50.0%). Thalassemic patients experienced significantly less 80/80/80 adherence, more ribavirin reduction and serious adverse events than controls. Notably, there was a decreased post-treatment RBC transfusion demand versus baseline in thalassemic patients with SVR (5.21 vs. 5.64?units/month, p ?=? 0.05 ), but not in those without SVR (6.33 vs. 6.56?units/month, p ?=? 0.54 ). Conclusion Peg-IFN/ribavirin was effective and tolerable for thalassemic HCV patients. Successful antiviral therapy might have extra benefit of reducing the post-treatment transfusion demand.
机译：背景/目的地中海贫血患者中普遍存在丙型肝炎病毒（HCV）。我们旨在研究聚乙二醇化干扰素（Peg-IFN）/利巴韦林治疗HCV地中海贫血患者的功效，安全性以及对红细胞（RBC）输血需求的影响。方法这项回顾性研究包括18例地中海贫血症患者（16例HCV-1b，1例HCV-1b / 2b和1例HCV-2b）和54例连续的性别和基因型匹配对照。 HCV-2或HCV-1或混合HCV-1 / 2的病毒载量较低且具有快速病毒学应答（RVR）的患者接受了24周的Peg-IFN /利巴韦林治疗;而病毒载量较高或无RVR的HCV-1或混合HCV-1 / 2则接受48周治疗。结果地中海贫血症患者的RVR，完全早期病毒学应答和持续病毒学应答（SVR）的发生率分别为72.2％（13/18），94.1％（16/17）和77.8％（14/18），与那些对照组（分别为63.0％，94.4％和81.5％）。地中海贫血组中，RVR是与SVR相关的唯一重要因素，并且是两组中SVR的最强预测因子（OR / 95％CI≤？14.7 / 2.20–98.6），其次是男性和较低的病毒载量。在患有SVR与非SVR的地中海贫血患者中观察到白介素28B-TT转运的比例更高（78.6％对50.0％）。地中海贫血症患者比对照组的80/80/80依从性明显降低，利巴韦林减少率更高，严重不良事件发生率也更高。值得注意的是，患有SVR的地中海贫血症患者的治疗后RBC输血需求相对于基线水平有所降低（5.21 vs. 5.64？单位/月，p？=？0.05），而没有SVR的地中海贫血患者则没有（6.33 vs. 6.56？units /月，p≤0.54。结论Peg-IFN /利巴韦林对地中海贫血的HCV患者有效且可耐受。成功的抗病毒治疗可能具有减少治疗后输血需求的额外好处。

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