Anemia Predicts Sustained Virological Response in Cirrhotic and Noncirrhotic Patients with Chronic Hepatitis C Treated with Peginterferon Alfa-2a and Ribavirin

Abstract

The aim of this post hoc analysis from four prospective clinical trials was to determine if the association between anemia and increased SVR occurs in patients with cirrhosis treated with peginterferon alfa-2a/ribavirin. The results suggest that rates of anemia were similar in patients with and without cirrhosis (hemoglobin ≤10 g/dL 17.9 vs 18.5 %; ≥3 g/dL decrease in hemoglobin 74.3 vs 70.6 %, respectively). SVR rates were consistently higher in noncirrhotic patients with and without anemia; however, within each cohort, SVR rates were considerably higher in patients who experienced a ≥3.0 g/dL drop in hemoglobin level. Among patients with cirrhosis, SVR rates with and without a ≥3.0 g/dL drop in hemoglobin were 30.6 and 17.7 %. SVR rates were similar in cirrhotic patients with or without hemoglobin levels dropping to ≤10.0 g/dL (29.9 vs 26.7 %). This analysis confirmed that SVR rates are higher in patients who experience a >3.0 g/dL drop in hemoglobin during treatment with peginterferon alfa-2a/ribavirin and, for the first time, showed that this phenomenon occurs in patients with cirrhosis.