Background

Chronic hepatitis C virus (HCV) infection is considered as one of the leading causes of liver disease in thalassemic patients in Iran. Over 40% of the mortality in these patients is related to HCV.

Objectives

The present study aimed at estimating HCV prevalence in thalassemic patients in Iran and to determine the number of infections until eradication is achieved.

Methods

A meta-analysis approach was used to estimate the number of HCV-infected thalassemic patients in the country. The prevalence rate was measured using a modeling approach to predict the number of cases until eradication using several scenarios in terms of testing and treatment, in particular the use of direct acting antiviral drugs (DAAs).

Results

With the advent of DAAs with a high rate of treatment success, HCV could be eradicated earlier than originally thought among this group of patients. Based on previous predictions the number of HCV-infected thalassemic patients would have been below 66 by 2020. However, according to our predictions, the number will be less than 10 when using DAAs.

Conclusion

We believe that HCV eradication can be achieved in thalassemic patients with an increased life expectancy by funding DAA-based new treatment strategies. This has been exemplified in Alborz, Lorestan, and South Khorasan provinces with HCV eradication in this group of patients.

中文翻译：

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使用各种治疗策略根除伊朗地中海贫血患者的丙型肝炎病毒感染

背景

慢性丙型肝炎病毒 (HCV) 感染被认为是伊朗地中海贫血患者肝病的主要原因之一。这些患者中超过 40% 的死亡率与 HCV 有关。

目标

本研究旨在估计伊朗地中海贫血患者的 HCV 流行率，并确定在实现根除之前的感染人数。

方法

采用荟萃分析方法估计该国感染 HCV 的地中海贫血患者的数量。流行率是使用建模方法来测量的，以预测直到根除的病例数，使用测试和治疗方面的几种方案，特别是使用直接作用抗病毒药物 (DAA)。

结果

随着治疗成功率高的 DAA 的出现，HCV 可以比最初认为的更早在这组患者中被根除。根据之前的预测，到 2020 年，感染 HCV 的地中海贫血患者的数量将低于 66 人。然而，根据我们的预测，使用 DAA 的人数将少于 10 人。

结论

我们相信，通过资助基于 DAA 的新治疗策略，可以在预期寿命延长的地中海贫血患者中实现 HCV 的根除。这已在厄尔布尔士、洛雷斯坦和南呼罗珊省的这组患者中根除 HCV 得到例证。