efficacy of prolonged treatment with pegylated interferon (peg-ifn) and ribavirin in thalassemic patients with hepatitis c who relapsed after previous peg-ifn-based therapy

background most thalassemic patients with chronic hepatitis c virus (hcv) infection do not respond to therapy with pegylated interferon (peg-ifn) plus ribavirin (rbv) due to hepatic siderosis and rbv dose reduction caused by rbv-induced anemia. objectives in the present study, we recruited hcv genotype 1-infected thalassemic patients who had relapsed after a 48-week treatment with peg-ifn plus rbv in order to evaluate the efficacy of a 72-week regimen of peg-ifn plus rbv. patients and methods in this retrospective study, 23 thalassemic patients with hcv genotype 1 infection who had prior relapse after treatment with peg-ifn and rbv for 48 weeks were consecutively enrolled in this study for evaluation of the efficacy of a 72-week treatment regimen. results for the 21 included cases, mean age was 29.7 years; 81% were men and 28.6% had cirrhosis. at the end of the treatment, nine (42.9%) patients had an undetectable level of hcv rna in their sera. however, six months after treatment completion four of these patients relapsed and a sustained virological response (svr) was found in five (23.8%) patients. undetectable hcv rna level at week 4 (p = 0.03) and undetectable hcv rna level at week 12 (p < 0.01) were found to be predictors of svr. there was an average 47.9% increase in blood transfusion during therapy and treatment was discontinued for 12 (57.1%) patients prematurely. conclusions the present study suggests that thalassemic patients with chronic hepatitis c genotype 1 infection who did not achieve svr after a course of therapy with peg-ifn and rbv may benefit from being retreated with a 72-week regimen.