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Ushering a New Era in the Management of Hepatitis C in Children with Hematological Disorders

  • Meena Sivasankaran
  • M Venkatadesikalu
  • V Mythili
  • Srinivas Sankaranarayanan
  • Dhaarani Jayaraman
  • Shivani Patel
  • Venkateswaran Vellaichamy Swaminathan
  • Ramya Uppuluri
  • Revathi Raj
Short Communication

Abstract

Transfusion-transmitted hepatitis C is a major concern among thalassemia patients. Our aim is to estimate the prevalence of Hepatitis C infection among thalassemia patients and to assess the treatment response, adverse effects of Peg-interferon based regimen and the new direct-acting antiviral drugs. Patients with thalassemia receiving regular blood transfusions with positive anti HCV antibodies during a period from January 2012 to June 2017 were analyzed. Serial HCV viral load and genotype and liver function tests were performed. Peg interferon and Ribavirin were used in patients diagnosed before January 2016 and patients diagnosed after January 2016 were started on the combination of Ledipasvir/Sofosbuvir. Thirty-two patients aged between 2 and 28 years were analyzed. Genotype 1 was the predominant type. Twenty-one patients were initiated on Peg Interferon with Ribavirin, and 14 achieved sustained virological response. All of them had increased blood transfusion requirements with significant compliance issues. All eleven patients started on Ledipasvir and Sofosbuvir including 4 undergoing hematopoietic stem cell transplantation and 7 interferon failures showed sustained viral clearance with good compliance. Ledipasvir/Sofosbuvir combination can be safely used in thalassemia patients and in young children. The cost of therapy is less compared to peg interferon based regimen with good compliance and superior efficacy.

Keywords

Hepatitis C Interferon Ledipasvir and Sofosbuvir Sustained viral response 

Abbreviations

HCV

Hepatitis C virus

AASLD

American Association for the Study of the Liver Disease

EASL

European Association for the Study of the Liver

DAAs

Direct acting anti virals

SVR

Sustained virological responcse

IFN

Interferon

LDV

Ledipasvir

SOF

Sofosbuvir

Notes

Compliance with Ethical Standards

Conflict of interest

All authors agree that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from the all the individual patients included in the study.

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Copyright information

© Indian Society of Hematology and Blood Transfusion 2018

Authors and Affiliations

  • Meena Sivasankaran
    • 1
  • M Venkatadesikalu
    • 2
  • V Mythili
    • 2
  • Srinivas Sankaranarayanan
    • 1
  • Dhaarani Jayaraman
    • 1
  • Shivani Patel
    • 1
  • Venkateswaran Vellaichamy Swaminathan
    • 1
  • Ramya Uppuluri
    • 1
  • Revathi Raj
    • 1
  1. 1.Department of Pediatric Hematology, Oncology, Blood and Marrow TransplantationApollo Cancer InstituteChennaiIndia
  2. 2.Voluntary Health Services Hospital Thalassemia CenterChennaiIndia

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