Epoetin alpha improves the response to antiviral treatment in HCV-related chronic hepatitis.
BACKGROUND
The conventional antiviral treatment of chronic hepatitis related to hepatitis C virus (HCV) often leads to anemia. In this case, it is necessary to reduce ribavirin dose or stop treatment, thus reducing the rate of sustained virological response.


OBJECTIVE
We investigated whether epoetin alpha administration improves treatment adherence and leads to higher percentage of response at the end of therapy and sustained virological response.


METHODS
Two hundred and fourteen individuals with genotype 1b HCV-related chronic hepatitis underwent treatment with pegylated (peg)-interferon alpha-2A 180 μg once weekly and ribavirin 1,000-1,200 mg/day; 174 were responders. Forty individuals completed treatment with no hemoglobin reduction; 134 developed anemia during therapy. Anemic responders were distributed randomly into two groups: group 1 continued therapy with epoetin alpha addiction; group 2 continued antiviral therapy with ribavirin reduction only.


RESULTS
Patients in group 1 achieved better control of hemoglobin levels (13.8 ± 1.2 g/dl at the end of therapy) than those in group 2 (11.5 ± 0.8 g/dl). Sustained virological response was 59.7% in group 1 compared with 34.4% in group 2 (p<0.01).


CONCLUSIONS
In patients with 1b HCV-related chronic hepatitis who develop anemia during antiviral treatment, administration of epoetin alpha increases hemoglobin levels and the end-of-treatment rate and sustains virological response by improving treatment adherence.
Bertino
Gaetano
G
Hepatology Unit, Department of Internal Medicine and Systemic Diseases, University of Catania, S. Marta Hospital, Via Gesualdo Clementi, 36, 95124 Catania, Italy. gaetanobertinounict@libero.it
Ardiri
Annalisa
A
Boemi
Patrizia Maria
PM
Calvagno
Giuseppe Stefano
GS
Ruggeri
Irene Maria
IM
Speranza
Annalisa
A
Santonocito
Maria Milena
MM
Ierna
Dario
D
Bruno
Cosimo Marcello
CM
Valenti
Maria
M
Boemi
Roberta
R
Naimo
Simona
S
Neri
Sergio
S
D000328:Adult; D000747:Anemia, Hypochromic / Q000139:chemically induced / Q000188:drug therapy*; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D005293:Ferritins / Q000097:blood; D006397:Hematinics / Q000627:therapeutic use*; D006454:Hemoglobins / Q000378:metabolism; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D011788:Quality of Life; D012367:RNA, Viral / Q000032:analysis; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D019562:Viral Load
D000998:Antiviral Agents; D006397:Hematinics; D006454:Hemoglobins; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D004921:Erythropoietin; D011092:Polyethylene Glycols; D012254:Ribavirin; D000068817:Epoetin Alfa; D005293:Ferritins; C100416:peginterferon alfa-2a