Hemoglobin Level can be a Predictor of End Treatment Response in Chronic Hepatitis C?

Abstract

Purpose: To study the correlation between hemoglobin level and end treatment response in chronic hepatitis C patients treated with conventional interferon and ribavirin. Methods: Chronic hepatitis C patients treated at Gastroenterology & Hepatology Division, Department of Medicine, Holy Family Hospital, Rawalpindi, Pakistan between January 2006 to August 2009. All patients were work-up with blood counts and ALT levels. Later, conventional interferon alpha 2b thrice a week + Ribavirin 800 mg daily for 6 months were prescribed. At treatment completion, end treatment response was determined. Data was collected on specially designed liver data file for each patient. Data was then transcribed into SPSS version 16 and analyzed. Results: Total of 422 patients were included in the study that dropped their hemoglobin levels with treatment with conventional interferon and ribavirin. 51% (n=215) were male and 49% (n=207) were female. Mean age of the patients was 35.79 + SD 8.408 years. Maximum patients 72.8% (n=307) were in the age range between 20-40 years. Youngest patient was of 15 years and oldest being of 58 years. Mean hemoglobin levels before and after the treatment were 14.04 +1.72 and 11.99+1.64 respectively. In the pretreatment period, maximum patients 39% (n=165) had hemoglobin range between 14-16 years while 40.8% (n=172) patients were having hemoglobin in the range of 10-12 mg/dl after treatment. Highest and lowest hemoglobin values in pre and post treatment patients were 18.50 mg/dl vs. 16.70 mg/dl and 10 mg/dl vs. 6.90 mg/dl respectively. Total of 422 patients who dropped their hemoglobin with conventional interferon and ribavirin treatment, 78.7% (n=332) dropped level between 0.1-3.0 mg/dl, 20.4% (n=86) between 3.1-6 and 0.9% (n=04) patients dropped hemoglobin more than 06 mg/dl. Considering the treatment response, 75.1% (n=317) achieved end treatment response while 24.9% (n=105) were non responder. Patient who dropped their hemoglobin from 0.1-3.0 mg/dl, 3.1-6.0 mg/dl, more than 6.1 mg/dl showed response rates 72.9%, 83.7% and 75% respectively while non responders frequencies were 27.1%, 16.3% and 25% respectively. P-value calculated using chi-square was 0.117 (95% Confidence Interval; Odd ratio 4.598) signifies that there is no positive correlation exists between the drop of hemoglobin levels and the end treatment response. Conclusion: There is no significant correlation between drop in hemoglobin level and treatment response in chronic hepatitis C patients treated with conventional interferon and ribavirin.