The frequency of respiratory infections in patients with chronic hepatitis C treated with pegylated-Interferon

Abstract

Background: The treatment with pegylated-Interferon (peg-IFN) in patients with chronic hepatitis C induces neutropenia, associated with multiple infections. This study aims to evaluate the frequency of respiratory infections and its relations with neutropenia in patients treated with peg-IFN. Methods: The Authors included in the study 64 patients with chronic hepatitis C treated with peg-IFN in the Clinic of Infectious Diseases Timisoara, between 2012 and 2014. The positive diagnosis of respiratory infections was based on clinical elements (fever, cough, expectoration, dyspnoea, etc.), biological tests (ESR, CRP, sputum culture, etc.) and the result of chest radiography. Neutropenia was defined as a decrease of the absolute neutrophil count (ANC) less than 1500/µL (mild between1000/µL -749/µL, moderate between 750/µL-500/µL and severe under 500/µL). Results: Of the study group (n=64), 18 patients (28.12%) were diagnosed with respiratory infections: 7 (10.93%) with tonsillitis, 5 (7.81%) with bronchitis, 4 (6.25%) with pneumonia and 2 patients (3.12%) with sinusitis. In the group with respiratory infections: 2 patients had mild neutropenia, 6 had moderate neutropenia and 10 had severe neutropenia. In the cases with moderate neutropenia the doses of peg-IFN were reduced to half of the initial doses, and in those cases with severe neutropenia the treatment with peg-IFN was temporarily stopped. Of the 18 patients, 15 were over 50 years and 3 were under 50 years (p=0.01). Conclusions: The high frequency of acute respiratory infections in patients treated with peg-IFN require rigorous monitoring in order to establish an early diagnosis of infections and an optimal therapy.