Baseline Factors Identify HIV-HCV Coinfected Patients Prone to Hematological Toxicity during Anti-HCV Therapy

In the current study, published in Antiviral Therapy, researchers assessed the baseline factors associated with hematological toxicity that lead to ribavirin or pegylated interferon dose reductions in hepatitis C and HCV-HIV coinfected patients.

This was a multicentre, prospective, observational study conducted at 11 hospitals in Spain during the period 2002–2003.

One-hundred and forty-two HIV/HCV-coinfected patients received peginterferon-alpha2a plus ribavirin.

Hematological parameters were recorded at baseline, week 4, 8, 12, 24 and 48. Cox’s regression model was used to study the factors associated with the appearance of a hemoglobin level below 10g/dl (hemoglobin endpoint), a neutrophil count below 750/mm3 (neutrophil-endpoint) and a platelet count below 50,000/mm3 (platelet-endpoint).

Results

Nineteen patients (13.4%) reached the hemoglobin-endpoint, 22.5% the neutrophil endpoint and 7% the platelet-endpoint.

Mean time of follow-up was 8 months (±3.5). A baseline hemoglobin level below 14g/dl and treatment with zidovudine (Retrovir) were the independent factors associated with the appearance of the hemoglobin endpoint.

A baseline neutrophil below 2050/mm3 and baseline weight <60 kg were independently associated with the appearance of the neutrophil endpoint.

Baseline platelet count (x1000/mm3 decrease) was independently associated with the appearance of the platelet-endpoint.

The authors conclude, “Baseline factors allow the identification of a subset of HIV-HCV coinfected patients who are prone to experience hematological toxicity during HCV antiviral therapy.”

12/02/05

Reference
D Fuster and others (for the PEG-TOX Research Group). Baseline factors associated with haematological toxicity that leads to a dosage reduction of pegylated interferon-alpha2a and ribavirin in HIV- and HCV coinfected patients on HCV antiviral therapy. Antiviral Therapy 10(7): 841-847. 2005.