Thursday, April 26, 2012

Patients with inherited anemias

CHC is common in patients with thalassemia major or sickle cell
disease, as a result of regular or intermittent red blood
transfusions. In addition to HCV injury, progression of liver
fibrosis is influenced by the degree of hepatic iron overload, with
high rates of cirrhosis and hepatocellular carcinoma (Angelucci
2002). With PegIFN/RBV combination, SVR has been reported in
40-70% of patients with thalassemia. Patients with thalassemia
major are at increased risk of AEs of interferon and careful
monitoring for side effects, iron chelation (with liver iron
maintained between 2-7 mg/g dry weight), and regular
transfusions may be necessary. These patients should be
managed preferably by a hepatologist and a hematologist, in a
joint clinic.

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