EFFECT OF STANDARD INTERFERON AND RIBAVIRIN ON HAEMOGLOBIN LEVEL IN HEPATITIS-C PATIENTS
AbstractBackground: The standard treatment for HCV infection involves combination therapy with pegylated interferon and ribavirin. The study was conducted to determine the effect of standard interferon and ribavirin on the haemoglobin level in patients treated for hepatitis-C. Methods: PCR confirmed 58 patients of chronic hepatitis-C treated with standard interferon and ribavirin for six months were included in this case series study. The patients were followed up monthly. Haemoglobin was measured by Sysmex Haematology analyser at monthly interval to study change in its level. Result: The study found decrease in the mean haemoglobin levels during the six months treatment. when the mean of baseline haemoglobin was compared with the mean haemoglobin of six months treatment, a decrease of 2.05 gm/dl was observed and the result was statistically significant (p=0.000). Conclusion: Six months treatment of chronic hepatitis-C with standard interferon and ribavirin decreases haemoglobin to a significant level causing anaemia in susceptible patients.Keywords: interferon, ribavirin, haemoglobin, hepatitis-C
Averhoff FM, Glass N, Holtzman D. Global birden of hepatitis C: considerations for health care providers in the United States. Clin Infect Dis 2012;Suppl 1:S10–5.
Lavanchy D. The global burden of hepatitis C. Liver Int2009;29(Suppl 1):74–81.
World Health Statistics. Geneva: World Health Organization.2008.
Zeuzem S, Feinman SV, Raseneck J, Heathcote EJ, Lai MY, Gane E. et al. Peginterferon alfa-2a in patients with chronic hepatitis C. N Engl J Med 2000;343(23):1666–72.
Peck-Radosavljevic M, Wichlas M, Homoncik-Kraml M, Kreil A, Hofer H, Jessner W, Gangl Aet al. Rapid suppression of hematopoiesis by standard or pegylated interferon-alpha. Gastroenterology 2002; 123:141–51.
Ghany MG, Strader DB, Thomas DL, Seeff LB. Diagnosis, management, and treatment of hepatitis C: An update. Hepatology2009;49:1335–74.
Bodenheimer HC, Lindsay KL, Davis GL, Lewis JH, Thung SN, Seeff LB. Tolerance and efficacy of oral ribavirin treatment of chronic hepatitis C: a multicenter trial. Hepatology 26(2):473–7.
Fellay J, Thompson AJ, Ge D, Gumbs CE, Urban TJ, Shianna KV. ITPA gene variants protect against anemia in patients treated for chronic hepatitis C.Nature2010;464(7287):405–8.
Brochot E, Castelain S, Duverlie G, Capron D, Nguyen-Khac E, François C. Ribavirin monitoring inchronic hepatitis C therapy:anaemia versus efficacy.AntivirTher 2010;15(5):687–95.
Russmann S, Grattagliano I, Portincasa P, PalmieriVO, Palasciano G. Ribavirin-induced anaemia: mechanisms, risk factors and related targets for future research. Curr Med Chem. 2006;13:3351–7.
EASL. Clinical practice guidelines: management of hepatitis C virus infection. J Hepatol 2011;55:245–64.
Ucciferri C1, Falasca K, Mancino P, De Tullio D, Pizzigallo E, Vecchiet J. High dose of erythropoietin in management of interferon/ribavirin induced anemia. Hepatogastroenterology 2007;54(80):2181–3.
PEG-IntronTM (recombinant peginterferon alfa-2b) package insert. Kenilworth, NJ: Schering Corporation, 2003.
Fried MW, Shiffman ML, Reddy KR, Smith C, Marinos G, Gonçales FL Jr et al. Peg-interferon alfa-2a plus ribavirin for chronic hepatitis C virus infection. N Engl J Med 2002;347:975–82.
Manns MP, McHutchison JG, Gordon SC, Rustgi VK, Shiffman M, Reindollar R et al. Peg-interferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomized trial. Lancet 2001; 358:958–65.
Afdhal NH, Dieterich DT, Pockros PJ, Schiff ER, Shiffman ML, Sulkowski MS et al. Epoetinalfa maintains ribavirin dose in HCV-infected patients: a prospective, double-blind, randomized controlled study. Gastroenterology 2004;126(5):1302–11.
De Franceschi L, Fattovich G, Turrini F, Ayi K, Brugnara C, Manzato F, et al. Hemolyticanemia induced by ribavirin therapy in patientswith chronic hepatitis C virus infection: role of membrane oxidative damage. Hepatology 2000;31(4):997–1004.
Dienstag JL. Chronic Hepatitis.In: Fauci, AS, Braunwald E, Kasper DL ,H auser SL ,Longo, DL, Jamseon JL. Harrison's Internal Medicine. 17th edition. USA: McGraw-Hill Companies,2008; p.1963–64.
Reau N, Hadziyannis SJ, Messinger D, Fried MW, Jensen DM.Early Predictors of anemia in patients, with hepatitis C genotype 1 treated with peginterferon alfa-2a (40KD) plus ribavirin. Am JGastroenterol2008;103(8):1981–8.
Maddrey WC. Safety of combination interferon alfa-2b/ribavirin therapy, in chronic hepatitis C-relapsed and treatment-naive patients. Semin Liver Dis 1999;19(Suppl 1):67–75.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.