High-dose vitamins E and C supplementation prevents ribavirin-induced hemolytic anemia in patients with chronic hepatitis C.
OBJECTIVE
In combination therapy using interferon (IFN) and ribavirin for chronic hepatitis C, reduced doses should be used due to ribavirin-induced hemolytic anemia. The present study aimed to elucidate whether high-dose vitamins E and C supplementation attenuated ribavirin-induced hemolytic anemia.


METHODS
Twenty-one consecutive patients with chronic hepatitis C were enrolled in this study between July 2003 and December 2004, and received high-dose vitamins E (2000 mg) and C (2000 mg) supplementation, daily, in addition to IFN alfa-2b and ribavirin combination therapy (vitamins E/C group). Twenty-one sex- and age-matched patients who received a standard regimen of IFN alfa-2b and ribavirin for chronic hepatitis C between January 2001 and June 2003 were evaluated as the control group.


RESULTS
Decrease in hemoglobin level was significantly prevented in the vitamins E and C group compared to that in the control group (P = 0.029). Three (14.3%) patients in the control group discontinued treatment because of anemia, while no treated patient dropped out of the study due to anemia. Sustained virological response was not significantly different between the two groups.


CONCLUSIONS
High-dose vitamins E and C supplementation prevented ribavirin-induced hemolytic anemia during combination therapy with ribavirin and IFN alfa-2b in patients with chronic hepatitis C.
Kawaguchi
Yasunori
Y
Department of Internal Medicine, Saga Medical School, Saga, Japan.
Mizuta
Toshihiko
T
Takahashi
Kazuhiro
K
Iwane
Shinji
S
Ario
Keisuke
K
Kawasoe
Hiroaki
H
Hamaoka
Kazuhiro
K
Eguchi
Yuichiro
Y
Yasutake
Tsutomu
T
Shigematsu
Hironao
H
Kawazoe
Seiji
S
Fukushima
Noriko
N
Ozaki
Iwata
I
Fujimoto
Kazuma
K