Hepatitis C Articles


Hematopoietic Growth Factors Counter Adverse Effects of Peginterferon plus Ribavirin and Help to Maintain SVR Rate in HCV Patients

Severe hematotoxicity is a common finding in chronic hepatitis C patients receiving peginterferon and ribavirin. The aim of the present study was to evaluate the benefits of hematopoietic growth factors (HGFs) during the treatment of chronic hepatitis C virus (HCV) infection that causes severe anemia and/or neutropenia.

This was a 1-year retrospective study of HCV positive patients receiving pegylated interferon and ribavirin. Patients received different HGFs, depending on certain criteria: they received erythropoietin (EPO) when their hemoglobin (Hb) levels were less than 10 g/dl and granulocyte colony-stimulating factor (G-CSF) when their neutrophil count was less than 750 cells/mm3.

Hematological data, adherence and virological response were analyzed and compared according to HGF use.

Results

In total, 132 patients were studied and 31 (23.5%) required HGF.

Under multivariate analysis, baseline Hb levels of less than 13g/dl or a drop in Hb levels of over 2% per week predicted severe anemia, and a baseline neutrophil count under 2900/mm3 predicted severe neutropenia.

HGF administration restored Hb values and the neutrophil count to above 10 g/dl and 1500 cells/mm3, respectively, in all 31 patients.

Adherence to antiviral treatment was achieved in 25% of patients versus 58% of controls without severe hematotoxicity.

The primary and sustained virological response did not differ statistically between HGF support and the control group (61% versus 57% and 32% versus 39%, respectively).


Based on these results, the authors conclude, "Hematopoietic growth factors administration counteracts the severe hematological adverse effects which occur during antiviral therapy and maintains the rate of sustained response."

05/12/06

Reference
P Lebray, B Nalpas, A Vallet-Pichard, and others. Antiviral Therapy 10: 769-776. 2005.


FDA-approved Monotherapies for HCV
Intron A
Roferon
Infergen
Pegasys
PEG-Intron
FDA-approved Combination Therapies for HCV
Pegasys + Copegus
PEG-Intron + Rebetol
Intron A + Rebetol
 Roferon A + Ribavirin