Abstract
Anemia associated with ribavirin (RBV) and interferon therapy in patients with chronic viral hepatitis C is a hemolytic, multifactorial adverse effect, in direct correlation with the RBV dose. Additionally, the anemic syndrome is worsened by the interferon-induced bone marrow suppression of erythroid precursors. The resulting anemia is associated with low production of erythropoietin, similar to anemia seen in HIV-infected patients or in those with cancer. Our study was performed on a group of 28 patients with viral hepatitis C treated with 3 MU interferon alfa 3 times a week and RBV 1000-1200 mg/day for 12 months. A normochromic normocytic anemia was observed, requiring a reduction of the RBV dose to 600 mg/day if the hemoglobin was below 10 g/dL and interrupted if the hemoglobin level was below 8.5 g/dL. In this case, reversibility can occur within a time interval of 4-8 weeks after discontinuation of treatment.
Highlights
Anemia associated with ribavirin (RBV) and interferon therapy in patients with chronic viral hepatitis C is a hemolytic, multifactorial adverse effect, in direct correlation with the RBV dose
Patients with chronic viral hepatitis C treated with IFN / PEG-IFN and RBV have multiple types of anemia: hemolytic anemia, nutritional defficiency anemia, simple chronic anemia or anemia resulting from bleeding, defining the concept of mixed anemia [4]
Hemolytic anemia is the major complication of RBV treatment resulting from the accumulation of RBV triphosphate in the red blood cells, which interferes with cellular functions [6-8]
Summary
The study was performed on a group of 28 patients with viral hepatitis C admitted to the Second Medical Clinic of the Emergency County Hospital of Craiova who received 3 MU of interferon alfa 3 times a week and RBV 1000 -1200 mg/day for 12 months. The data obtained was correlated with additional data (anamnestic, serological and histological) from the patient records or the observation sheets. This information was entered into a Microsoft Office Excel database and processed statistically. We evaluated and compared the safety of the therapeutic agents included in the therapeutic protocols by performing the appropriate analysis sets and the subsequent statistical analysis the main haematological parameters involved in the antiviral treatment management. These results were correlated with sustained virological response, which evaluates the effectiveness of the treatment
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