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- Title
Early decline of hemoglobin can predict progression of hemolytic anemia during pegylated interferon and ribavirin combination therapy in patients with chronic hepatitis C.
- Authors
Hiramatsu, Naoki; Kurashige, Nao; Oze, Tsugiko; Takehara, Tetsuo; Tamura, Shinji; Kasahara, Akinori; Oshita, Masahide; Katayama, Kazuhiro; Yoshihara, Harumasa; Imai, Yasuharu; Kato, Michio; Kawata, Sumio; Tsubouchi, Hirohito; Kumada, Hiromitsu; Okanoue, Takeshi; Kakumu, Shinichi; Hayashi, Norio
- Abstract
Aim: Ribavirin, used to treat chronic hepatitis C, can induce hemolytic anemia, forcing the discontinuance of treatment. To establish a predictive measure to help circumvent this, we evaluated the relationship of hemoglobin (Hb) decline with the discontinuance of treatment during the progression of ribavirin-induced anemia. Methods: One hundred and sixteen patients (71% male) with genotype 1 chronic hepatitis C were treated with pegylated interferon (PegIFN) α-2b and ribavirin. The mean age was 50.6 years and 55% were IFN naïve. A decline of Hb concentration by 2 g/dL at two weeks from the start of the treatment (“2 by 2” standard) was adopted as the predictive factor for the progression of anemia. Results: By applying the “2 by 2” standard, with ΔHb ≥ 2 g/dL (34%, n = 39), treatment was discontinued in 12 cases (31%), three of which (8%) because of severe anemia. ForΔHb < 2 g/dL (64%, n = 76), treatment was discontinued in 11 (14%) cases; none due to severe anemia. Ten percent (4/39) of patients showed the minimum Hb ≤ 8.5 g/dL in the ΔHb ≥ 2 g/dL group, with none in the ΔHb < 2 g/dL group ( P = 0.001). Furthermore, the patients with minimum Hb ≤ 8.5 g/dL were found only in the “2 by 2” standard-positive and low CL/F (<15) group (4/29, 14%). Conclusion: Monitoring the Hb decline using the “2 by 2” standard can identify patients who are prone to developing severe anemia. Further prospective studies are needed using ribavirin reduction based on the “2 by 2” standard.
- Subjects
HEPATITIS C; RIBAVIRIN; HEMOLYTIC anemia; ANTINEOPLASTIC agents; GENETIC polymorphisms; HEMOGLOBIN polymorphisms
- Publication
Hepatology Research, 2008, Vol 38, Issue 1, p52
- ISSN
1386-6346
- Publication type
Article
- DOI
10.1111/j.1872-034X.2007.00205.x