Skip to main content
Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2003 Sep;95(9):864-7, 872-4.

HCV in sickle cell disease.

Mohamed Hassan 1, Syed Hasan 1, Oswaldo Castro 1, Samuel Giday 1, Alpha Banks 1, Duane Smoot 1
PMCID: PMC2594471  PMID: 14527056

Abstract

The sickle cell gene is common in the U.S. In fact 8% of African Americans are healthy carriers of the sickle cell trait (HbAS). People who are homozygous (HbSS) have severe disease. They have life-long anemia, chronic hemolysis, and also have at times hematological crises, which can worsen the anemia. Many patients require chronic transfusions and as a result, substantial proportions of sickle cell patients are at high risk for infection with blood-borne diseases-such as Hepatitis C Virus infection (HCV). The HCV antibody positivity is directly related to the number of transfusions given, and on average the prevalence rate in transfused patients is more than 10%. It is known that the combination of iron overload and HCV can lead to a more rapidly progressive liver disease. The treatment of HCV in sickle cell patients poses a challenge to clinicians. A novel approach described by some is the pre-treatment of these patients with hydroxyurea to increase the fetal hemoglobin, therefore decreasing the severity of Ribavirin-related hemolysis. Treatment with Peg-interferon alone has not been used to treat HCV in sickle cell patients, but in the setting of controlled clinical trials it would be feasible. This review explores the impact of HCV in sickle cell patients and the possible therapeutic options available to them.

Full text

PDF
864

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adewuyi J. O. Prevalence of antibodies to hepatitis C virus among normal blood donors and multi-transfused sickle-cell anaemia patients in Nigeria. Trop Doct. 1996 Jan;26(1):29–30. doi: 10.1177/004947559602600111. [DOI] [PubMed] [Google Scholar]
  2. Alter M. J., Kruszon-Moran D., Nainan O. V., McQuillan G. M., Gao F., Moyer L. A., Kaslow R. A., Margolis H. S. The prevalence of hepatitis C virus infection in the United States, 1988 through 1994. N Engl J Med. 1999 Aug 19;341(8):556–562. doi: 10.1056/NEJM199908193410802. [DOI] [PubMed] [Google Scholar]
  3. Bauer T. W., Moore G. W., Hutchins G. M. The liver in sickle cell disease. A clinicopathologic study of 70 patients. Am J Med. 1980 Dec;69(6):833–837. doi: 10.1016/s0002-9343(80)80008-8. [DOI] [PubMed] [Google Scholar]
  4. Charache S. Treatment of sickle cell anemia. Annu Rev Med. 1981;32:195–206. doi: 10.1146/annurev.me.32.020181.001211. [DOI] [PubMed] [Google Scholar]
  5. Conry-Cantilena C., VanRaden M., Gibble J., Melpolder J., Shakil A. O., Viladomiu L., Cheung L., DiBisceglie A., Hoofnagle J., Shih J. W. Routes of infection, viremia, and liver disease in blood donors found to have hepatitis C virus infection. N Engl J Med. 1996 Jun 27;334(26):1691–1696. doi: 10.1056/NEJM199606273342602. [DOI] [PubMed] [Google Scholar]
  6. Cribier B., Rey D., Schmitt C., Lang J. M., Kirn A., Stoll-Keller F. High hepatitis C viraemia and impaired antibody response in patients coinfected with HIV. AIDS. 1995 Oct;9(10):1131–1136. doi: 10.1097/00002030-199510000-00003. [DOI] [PubMed] [Google Scholar]
  7. Davis G. L., Lau J. Y. Factors predictive of a beneficial response to therapy of hepatitis C. Hepatology. 1997 Sep;26(3 Suppl 1):122S–127S. doi: 10.1002/hep.510260721. [DOI] [PubMed] [Google Scholar]
  8. DeVault K. R., Friedman L. S., Westerberg S., Martin P., Hosein B., Ballas S. K. Hepatitis C in sickle cell anemia. J Clin Gastroenterol. 1994 Apr;18(3):206–209. doi: 10.1097/00004836-199404000-00006. [DOI] [PubMed] [Google Scholar]
  9. Fargion S., Piperno A., Cappellini M. D., Sampietro M., Fracanzani A. L., Romano R., Caldarelli R., Marcelli R., Vecchi L., Fiorelli G. Hepatitis C virus and porphyria cutanea tarda: evidence of a strong association. Hepatology. 1992 Dec;16(6):1322–1326. doi: 10.1002/hep.1840160603. [DOI] [PubMed] [Google Scholar]
  10. Frank C., Mohamed M. K., Strickland G. T., Lavanchy D., Arthur R. R., Magder L. S., El Khoby T., Abdel-Wahab Y., Aly Ohn E. S., Anwar W. The role of parenteral antischistosomal therapy in the spread of hepatitis C virus in Egypt. Lancet. 2000 Mar 11;355(9207):887–891. doi: 10.1016/s0140-6736(99)06527-7. [DOI] [PubMed] [Google Scholar]
  11. Fried M. W., Hoofnagle J. H. Therapy of hepatitis C. Semin Liver Dis. 1995 Feb;15(1):82–91. doi: 10.1055/s-2007-1007265. [DOI] [PubMed] [Google Scholar]
  12. Haddad J., Deny P., Munz-Gotheil C., Ambrosini J. C., Trinchet J. C., Pateron D., Mal F., Callard P., Beaugrand M. Lymphocytic sialadenitis of Sjögren's syndrome associated with chronic hepatitis C virus liver disease. Lancet. 1992 Feb 8;339(8789):321–323. doi: 10.1016/0140-6736(92)91645-O. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Hasan M. F., Marsh F., Posner G., Bellevue R., Dosik H., Suatengco R., Ramani N. Chronic hepatitis C in patients with sickle cell disease. Am J Gastroenterol. 1996 Jun;91(6):1204–1206. [PubMed] [Google Scholar]
  14. Howell C., Jeffers L., Hoofnagle J. H. Hepatitis C in African Americans: summary of a workshop. Gastroenterology. 2000 Nov;119(5):1385–1396. doi: 10.1053/gast.2000.19582. [DOI] [PubMed] [Google Scholar]
  15. Ikeda K., Saitoh S., Koida I., Arase Y., Tsubota A., Chayama K., Kumada H., Kawanishi M. A multivariate analysis of risk factors for hepatocellular carcinogenesis: a prospective observation of 795 patients with viral and alcoholic cirrhosis. Hepatology. 1993 Jul;18(1):47–53. [PubMed] [Google Scholar]
  16. Kindscher J. D., Laurin J., Delcore R., Forster J. Liver transplantation in a patient with sickle cell anemia. Transplantation. 1995 Oct 15;60(7):762–764. doi: 10.1097/00007890-199510150-00026. [DOI] [PubMed] [Google Scholar]
  17. King S. D., Dodd R. Y., Haynes G., Wynter H. H., Sullivan M. T., Serjeant G. R., Choo-Kang E., Michael E. Prevalence of antibodies to hepatitis C virus and other markers in Jamaica. West Indian Med J. 1995 Jun;44(2):55–57. [PubMed] [Google Scholar]
  18. Lang T., Berquist W. E., So S. K., Cox K. L., Rich E. J., Vichinsky E., Concepcion W., Esquivel C. O. Liver transplantation in a child with sickle cell anemia. Transplantation. 1995 May 27;59(10):1490–1492. doi: 10.1097/00007890-199505270-00025. [DOI] [PubMed] [Google Scholar]
  19. McHutchison J. G., Gordon S. C., Schiff E. R., Shiffman M. L., Lee W. M., Rustgi V. K., Goodman Z. D., Ling M. H., Cort S., Albrecht J. K. Interferon alfa-2b alone or in combination with ribavirin as initial treatment for chronic hepatitis C. Hepatitis Interventional Therapy Group. N Engl J Med. 1998 Nov 19;339(21):1485–1492. doi: 10.1056/NEJM199811193392101. [DOI] [PubMed] [Google Scholar]
  20. Okuda M., Hino K., Korenaga M., Yamaguchi Y., Katoh Y., Okita K. Differences in hypervariable region 1 quasispecies of hepatitis C virus in human serum, peripheral blood mononuclear cells, and liver. Hepatology. 1999 Jan;29(1):217–222. doi: 10.1002/hep.510290117. [DOI] [PubMed] [Google Scholar]
  21. Poynard T., Bedossa P., Opolon P. Natural history of liver fibrosis progression in patients with chronic hepatitis C. The OBSVIRC, METAVIR, CLINIVIR, and DOSVIRC groups. Lancet. 1997 Mar 22;349(9055):825–832. doi: 10.1016/s0140-6736(96)07642-8. [DOI] [PubMed] [Google Scholar]
  22. Poynard T., Marcellin P., Lee S. S., Niederau C., Minuk G. S., Ideo G., Bain V., Heathcote J., Zeuzem S., Trepo C. Randomised trial of interferon alpha2b plus ribavirin for 48 weeks or for 24 weeks versus interferon alpha2b plus placebo for 48 weeks for treatment of chronic infection with hepatitis C virus. International Hepatitis Interventional Therapy Group (IHIT) Lancet. 1998 Oct 31;352(9138):1426–1432. doi: 10.1016/s0140-6736(98)07124-4. [DOI] [PubMed] [Google Scholar]
  23. Rosenblate H. J., Eisenstein R., Holmes A. W. The liver in sickle cell anemia. A clinical-pathologic study. Arch Pathol. 1970 Sep;90(3):235–245. [PubMed] [Google Scholar]
  24. Ross Andrew S., Graeme-Cook Fiona, Cosimi A. Benedict, Chung Raymond T. Combined liver and kidney transplantation in a patient with sickle cell disease. Transplantation. 2002 Feb 27;73(4):605–608. doi: 10.1097/00007890-200202270-00022. [DOI] [PubMed] [Google Scholar]
  25. Swaim M. W., Agarwal S., Rosse W. F. Successful treatment of hepatitis C in sickle-cell disease. Ann Intern Med. 2000 Nov 7;133(9):750–751. doi: 10.7326/0003-4819-133-9-200011070-00033. [DOI] [PubMed] [Google Scholar]
  26. Vichinsky E. P. Comprehensive care in sickle cell disease: its impact on morbidity and mortality. Semin Hematol. 1991 Jul;28(3):220–226. [PubMed] [Google Scholar]
  27. Vichinsky E. P. Current issues with blood transfusions in sickle cell disease. Semin Hematol. 2001 Jan;38(1 Suppl 1):14–22. doi: 10.1016/s0037-1963(01)90056-3. [DOI] [PubMed] [Google Scholar]
  28. Yano M., Kumada H., Kage M., Ikeda K., Shimamatsu K., Inoue O., Hashimoto E., Lefkowitch J. H., Ludwig J., Okuda K. The long-term pathological evolution of chronic hepatitis C. Hepatology. 1996 Jun;23(6):1334–1340. doi: 10.1002/hep.510230607. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES