Hematologic disorders associated with hepatitis C virus infection and their management.
More than 4 million people in the United States are infected with hepatitis C virus (HCV). During the next 20-30 years, the burden of HCV-related mortality and morbidity will likely double. To date, the most effective treatment for chronic HCV infection is the combination of either interferon (IFN)-alpha or pegylated IFN-alpha and ribavirin. For a sustained virologic response, treatment adherence and dose maintenance are essential. However, both IFN-alpha and ribavirin induce hematologic toxicity, such as anemia, neutropenia, and thrombocytopenia, which can compromise treatment adherence and dose maintenance and could, therefore, potentially influence outcomes. Although there are currently no approved treatments for hematologic complications of HCV therapy, studies have shown that hematopoietic growth factors can provide significant benefits. This review highlights the pharmacology, risks, and benefits of recombinant hematopoietic growth factor therapy in HCV-infected patients.
Dieterich
Douglas T
DT
Department of Medicine, Mount Sinai Medical Center, New York, New York, USA. douglas.dieterich@msnyuhealth.org
Spivak
Jerry L
JL
D000998:Antiviral Agents / Q000009:adverse effects; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006402:Hematologic Diseases / Q000139:chemically induced / Q000150:complications* / Q000188:drug therapy; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects; D017370:Interleukin-11 / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D012254:Ribavirin / Q000009:adverse effects; D014481:United States
D000998:Antiviral Agents; D016898:Interferon-alpha; D017370:Interleukin-11; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D012254:Ribavirin