TY - JOUR
TI - Liver disease in adult transfusion-dependent beta-thalassaemic patients:
investigating the role of iron overload and chronic HCV infection
AU - Kountouras, Dimitrios
AU - Tsagarakis, Nikolaos J.
AU - Fatourou,
AU - Evangelia
AU - Dalagiorgos, Efthimios
AU - Chrysanthos, Nikolaos and
AU - Berdoussi, Helen
AU - Vgontza, Niki
AU - Karagiorga, Markissia and
AU - Lagiandreou, Athanasios
AU - Kaligeros, Konstantinos
AU - Voskaridou, Ersi
AU - and Roussou, Paraskevi
AU - Diamanti-Kandarakis, Evanthia
AU - Koskinas,
AU - John
JO - Liver International
PY - 2013
VL - 33
TODO - 3
SP - 420-427
PB - Wiley
SN - 1478-3223, 1478-3231
TODO - 10.1111/liv.12095
TODO - HCV; iron; liver fibrosis; thalassaemia
TODO - Background Iron overload and hepatitis-C virus (HCV) infection, have
been implicated in the evolution of liver disease, in patients with
transfusion-dependent beta-thalassaemia major (BTM). However, the impact
of these factors in late stages of liver disease in adults with BTM, has
not been extensively studied. Aims To investigate serum indices of iron
overload, HCV infection and liver disease, in a cohort of 211 adult
Greek patients with BTM, in relation with the findings from liver
biopsies. Methods In this cross-sectional study, 211 patients with BTM
were enrolled and studied, in relation with HCV infection, ferritin,
transaminases, chelation treatment and antiviral treatment. Based on 109
patients biopsied, we correlated liver fibrosis, haemosiderosis and
inflammation, with serum indices and HCV status Results Among all
patients, 74.4% were anti-HCV positive (HCV+). Ferritin was positively
correlated with transaminases and negatively correlated with age, while
it was not significantly different among HCV+ and HCV patients. Among
the HCV+ patients, 55.4% reported antiviral treatment, while genotype 1
predominated. In a subfraction of 109 patients, in which liver biopsy
was performed, 89% were HCV+ and 11% HCV. Fibrosis was significantly
correlated with age (P=0.046), AST (P=0.004), ALT (P=0.044) and
inflammation (P<0.001). Advanced fibrosis was present with even minimal
haemosiderosis, independently of ferritin values or HCV history.
Conclusions These data suggest that in the late stages of liver disease
in BTM patients, iron overload may be the critical determinant, since
fibrosis is related to the minimal haemosiderosis, independently of HCV
history.
ER -