Erythropoietic Response to Anemia in Chronic Hepatitis C Patients Receiving Combination Pegylated Interferon/Ribavirin
- 1 February 2005
- journal article
- research article
- Published by Wolters Kluwer Health in American Journal of Gastroenterology
- Vol. 100 (2), 299-307
- https://doi.org/10.1111/j.1572-0241.2005.40757.x
Abstract
In hepatitis C virus (HCV)-infected patients receiving pegylated interferon (PEG-IFN)/ribavirin (RBV) combination therapy, anemia is a well-known side effect. The purpose of this study was to describe the time course and extent of hemoglobin (Hb) changes and the erythropoietic response to PEG-IFN/RBV-induced anemia. In this multicenter, observational, 8-wk study, laboratory parameters were measured weekly for 8 wk or until early withdrawal. Primary endpoints included changes in Hb and serum erythropoietin (sEPO) from baseline to week 8; other measures were changes in reticulocytes and RBV dose. The predictive value of baseline factors for maximum Hb decline was assessed. In the 97 evaluable patients, mean Hb decreased from 14.4 ± 1.4 g/dl (baseline) to 11.9 ± 1.3 g/dl (week 8). Twenty-one percent of patients withdrew before week 8. The estimated erythropoietic response was lower than that seen in two historic control populations of iron deficiency anemia patients. Mean RBV dose decreased from 986 ± 190 mg/day (baseline) to 913 ± 228 mg/day (week 8). Fifty-seven out of 77 (74%) patients who completed the study maintained their initial prescribed RBV dose. Patients maintained on the initial dose of RBV who had a higher baseline Hb and viral load showed a trend toward larger Hb declines. Platelets and white blood cells (WBCs) also declined during the study. HCV-infected patients receiving PEG-IFN/RBV therapy have reductions in Hb, platelets, and WBCs, possibly due to bone marrow suppression. They also have diminished endogenous sEPO production for their degree of anemia.Keywords
This publication has 18 references indexed in Scilit:
- Changes in haemoglobin during interferon alpha‐2b plus ribavirin combination therapy for chronic hepatitis C virus infectionJournal of Viral Hepatitis, 2004
- Peginterferon Alfa-2a and ribavirin in patients with chronic hepatitis C who have failed prior treatment[1], [2] and [3] 1 2 3☆Gastroenterology, 2004
- Peginterferon-α2a and Ribavirin Combination Therapy in Chronic Hepatitis CAnnals of Internal Medicine, 2004
- Early virologic response to treatment with peginterferon alfa-2b plus ribavirin in patients with chronic hepatitis CHepatology, 2003
- Adherence to combination therapy enhances sustained response in genotype-1–infected patients with chronic hepatitis CGastroenterology, 2002
- Peginterferon Alfa-2a plus Ribavirin for Chronic Hepatitis C Virus InfectionNew England Journal of Medicine, 2002
- Rapid suppression of hematopoiesis by standard or pegylated interferon-αGastroenterology, 2002
- Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trialThe Lancet, 2001
- The blood in systemic disordersThe Lancet, 2000
- Tolerance and efficacy of oral ribavirin treatment of chronic hepatitis C: A multicenter trialHepatology, 1997