@article{3108562,
    title = "Treatment of chronic hepatitis C with direct-acting antivirals in patients with β-thalassaemia major and advanced liver disease",
    author = "Sinakos, E. and Kountouras, D. and Koskinas, J. and Zachou, K. and Karatapanis, S. and Triantos, C. and Vassiliadis, T. and Goulis, I. and Kourakli, A. and Vlachaki, E. and Toli, B. and Tampaki, M. and Arvaniti, P. and Tsiaoussis, G. and Bellou, A. and Kattamis, A. and Maragkos, K. and Petropoulou, F. and Dalekos, G.N. and Akriviadis, E. and Papatheodoridis, G.V.",
    journal = "British Journal of Haematology",
    year = "2017",
    volume = "178",
    number = "1",
    pages = "130-136",
    publisher = "Wiley-Blackwell Publishing Ltd",
    issn = "0007-1048, 1365-2141",
    doi = "10.1111/bjh.14640",
    keywords = "daclatasvir;  dasabuvir;  deferiprone;  deferoxamine;  ledipasvir plus sofosbuvir;  ombitasvir plus paritaprevir plus ritonavir;  ribavirin;  simeprevir;  sofosbuvir;  antivirus agent;  BMS-790052;  imidazole derivative;  ribavirin;  simeprevir;  sofosbuvir, adult;  antiviral therapy;  Article;  blood transfusion;  chelation therapy;  chronic hepatitis C;  clinical article;  combination drug therapy;  drug efficacy;  drug safety;  drug tolerability;  female;  Hepatitis C virus genotype 1;  Hepatitis C virus genotype 2;  Hepatitis C virus genotype 3;  Hepatitis C virus genotype 4;  human;  liver cirrhosis;  male;  middle aged;  priority journal;  thalassemia major;  beta thalassemia;  chronic hepatitis C;  clinical trial;  complication;  genetics;  genotype;  Hepacivirus;  isolation and purification;  liver cirrhosis;  multicenter study;  severity of illness index;  virology, Adult;  Antiviral Agents;  beta-Thalassemia;  Drug Therapy, Combination;  Female;  Genotype;  Hepacivirus;  Hepatitis C, Chronic;  Humans;  Imidazoles;  Liver Cirrhosis;  Male;  Middle Aged;  Ribavirin;  Severity of Illness Index;  Simeprevir;  Sofosbuvir",
    abstract = "Interferon-based regimens for chronic hepatitis C (CHC) were often deferred in patients with β-thalasaemia major (β-TM) due to poor efficacy and tolerance. Current guidelines recommend direct-acting antivirals (DAAs) for these patients. The aim of this study was to assess the safety and efficacy of DAAs in patients with β-TM and advanced liver disease due to CHC. Patients were recruited from eight liver units in Greece. The stage of liver disease was assessed using transient elastography and/or liver histology. Five regimens were used: sofosbuvir (SOF) + ribavirin (RBV); SOF + simeprevir ± RBV; SOF + daclatasvir ± RBV; ledipasvir/SOF ± RBV and ombitasvir/paritaprevir-ritonavir + dasabuvir ± RBV. Sixty-one patients (median age 43 years) were included. The majority of patients was previously treated for hepatitis C (75%) and had cirrhosis (79%). Viral genotype distribution was: G1a: n = 10 (16%); G1b: n = 22 (36%); G2: n = 2 (3%); G3: n = 14 (23%); G4: n = 13 (22%). The predominant chelation therapy was a combination of deferoxamine and deferiprone (35%). Overall sustained virological response rates were 90%. All treatment regimens were well tolerated and no major adverse events or drug-drug interactions were observed. Approximately half of the patients who received RBV (7/16, 44%) had increased needs for blood transfusion. Treatment of CHC with DAAs in patients with β-TM and advanced liver disease was highly effective and safe. © 2017 John Wiley & Sons Ltd"
}