A major side effect of combination antiviral therapy is the development of anemia, which is more severe among the Asian population.
Dr Chuan-Mo Lee and colleagues from Taiwan explored the incidence, risk factors, and impact on treatment response of anemia in chronic Hepatitis C patients.
The team evaluated 466 Hepatitis C patients receiving combination antiviral therapy for 24 weeks.
Patients were treated with either interferon-α-2b 3 or 5 million units thrice weekly, or pegylated-interferon-α-2b 1-1.5 μg/kg weekly plus ribavirin 1000 to 1200 mg/day.
The investigators defined severe anemia as a hemoglobin concentration less than 10 g/dl.
The mean decrease of hemoglobin was 4 g/dl.
|39% of patients had developed severe anemia during therapy|
The investigators found that 39% of patients had developed severe anemia during therapy.
Stepwise logistic regression analysis revealed that age over 50 years, and baseline hemoglobin level were correlated with maximal decreases in hemoglobin.
The investigators used Cox's regression analysis to determine that pretreatment platelet counts, and old age were independent risk factors of severe anemia.
The team also noted that female gender, and low body weight were independent factors contributing to severe anemia.
There was a significant linear correlation between the sustained virological response rate and the time of severe anemia during therapy.
The investigators observed this correlation especially among genotype 1 patients.
Dr Lee's team comments, “Careful monitoring of hemoglobin level is necessary in patients who are old, female and have low body weight and platelet counts.”
“Development of severe anemia was significantly correlated with sustained virological response rate.”