title: Incidence and severity of infections according to the development of neutropenia during combined therapy with pegylated interferon-alpha2a plus ribavirin in chronic hepatitis C infection.
abstract: The evolution of treatment of chronic hepatitis C virus infection has led to improved therapeutic efficacy. However, a major problem is the presence of side effects that require modification or withdrawal of drug therapy in 15-20% of cases. This could potentially influence the lack of sustained viral response in 50% of the cases. Side effects are common, even with pegylated interferon. This study aimed to assess the incidence and severity of infections based on the development of neutropenia associated with combined therapy with pegylated interferon-alpha2a plus ribavirin in 209 patients with chronic hepatitis C infection. All patients were administered pegylated interferon-alpha2a (180 microg/week) plus ribavirin (800 mg/day for 24 weeks in cases of nongenotype 1, or 1000-1200 mg/day for 48 weeks for genotype 1, according to whether patients weighed more or less than 75 kg). Patients with preexisting neutropenia of any cause or cirrhosis were excluded. Neutropenia was defined as a neutrophil count (NC) of <1500 cells/microl. Neutropenia was classified into three levels during treatment: 750<or=NC<1500 (level 1), 500<or=750 (level 2), and NC<500 cells/microl (level 3). Of the 209 patients, 114 did not develop neutropenia (mean 2100+/-804 cells/microl), while 95 had an NC<1500 cells/microl (mean 1100+/-250 cells/microl). It was found that patients who developed neutropenia during treatment of chronic hepatitis C virus infection with a combined therapy based on pegylated interferon-alpha2a plus ribavirin did not show a higher infection rate or increased severity of the disease.
authors.affiliation: Servicio de Gastroenterologia, Hospital de Especialidades, Centro Medico Nacional Siglo XXI, Mexico, DF, Mexico. juarezalberto@yahoo.com.mx
authors.forename: A
authors.initials: A
authors.lastname: Juarez-Navarro
authors.forename: L
authors.initials: L
authors.lastname: Vera-de-León
authors.forename: J M
authors.initials: JM
authors.lastname: Navarro
authors.forename: R
authors.initials: R
authors.lastname: Chirino-Sprung
authors.forename: M
authors.initials: M
authors.lastname: Díaz-Hernandez
authors.forename: L
authors.initials: L
authors.lastname: Casillas-Davila
authors.forename: M
authors.initials: M
authors.lastname: Dehesa-Violante
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D007958:Leukocyte Count; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced* / Q000473:pathology; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D012254:Ribavirin / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin