الفهرس 
Hepatitis C VirusOnly 14 pages are availabe for public view
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Abstract
Thalassemia is one of the most common inherited single
gene disorder which is caused by point gene mutation
resulting in abnormal hemoglobin production, Due to lifelong
dependency for blood-transfusion, patients are
susceptible Hepatitis-C Virus infection, the major liverrelated
causes of death in such patients are cirrhosis and
hepatocellular carcinoma so Chelation therapy with new
drugs in addition to treatment of HCV seems to prevent
cardiac and liver damage and improve survival
The recent license of Direct Acting Antivirals (DAAs)
opened new venues in the treatment of CHC regarding
extremely high SVR rates and better compliance due to their
oral route of administration and the rarity of significant side
effects. The recent EASL treatment recommendations on
hepatitis C suggest that patients with haemoglobinopathies
should be treated with an IFN-free regimen without ribavirin.
However, patients with haemoglobinopathies and CHC
have been excluded from the major clinical trials that led to
the approval of DAAs, Hence, at present, no experience is
available regarding the safety and efficacy of DAAs in this
population.In this study, the Efficacy, Safety and Tolerability of
the new DAAs drugs (Sofosbuvir and Daclatasvir) were
studied among 200 patients classified into 2 groups, where
group (I) included 150 HCV-Thalassemic patients and group
(II) included 50 HCV only patients, each group divided into
2 subgroups, Easy to treat (a) and Difficult to treat (b)
according to NCCVH protocol.
Few patients in the study suffered from minor side
effects as headache, constipations, nausea, discomfort, and
fatigue and didn‘t require cessation of treatment in any
patient and were managed conservatively. While only four
patients from 150 HCV-thalassemic suffered from major
complications during treatment course, were two patients
suffered from hepatic fulmination and two patients suffered
from HCC requiring cessation of treatment.
All patients in our study groups (100%) tolerated the
DAAs treatment course very good without any intention to
stop their treatment course -with the exception of the 4
patients who developed major complications and forced to
stop the treatment course.
There was significant improvement in liver profile,
FIB4 score and fibrosis risk Among HCV-Thalassemic
patients when their results after treatment was compared with
their results before treatment.There was significant improvement of HGB level
among HCV-Thalaasemic patients when their HGB level
after treatment was compared with their HGB level before
treatment.
There was any need to change or modify dose of
chelating agents nor any side effects or interaction between
them and DAAs drugs during treatment course.
There was decrease in the transfusion requirements
(units/month) among HCV-Thalassemic patients when their
needs after treatment were compared with their needs before
treatment.
The Efficacy of treatment (SVR) was achieved in 134
out of 150 HCV-Thalassemic patients in group (I) (89.33%).
And in 46 out of 50 HCV only patients in group (II) (92%).