title: Severe neutropenia in patients with chronic hepatitis C: a benign condition.
abstract: OBJECTIVE
  Patients with chronic hepatitis C virus (HCV) infection may develop neutropenia, which can delay or prevent treatment. Severe neutropenia, absolute neutrophil counts (ANC) ≤0.500 × 10(9)/l, is a rare finding, with only two isolated reports published in the literature. The aim of this study was to evaluate the incidence and natural history of severe neutropenia in hepatitis C patients.
  
  
  METHODS
  The records of 685 patients with active HCV were reviewed to identify those with severe neutropenia. The laboratory parameters and clinical history data of patients with severe neutropenia were then compared to a cohort of patients with HCV patients who had the more common minor neutropenia (ANC = 1.000-1.500 10(9)/l).
  
  
  RESULTS
  There was no significant difference in race, MELD (Model for End Stage Liver Disease) scores, portal hypertension, splenomegaly, viral load, viral type, or hemoglobin or platelet levels. Neither group suffered serious systemic infections.
  
  
  CONCLUSIONS
  Severe neutropenia in HCV patients is underreported and not associated with serious HCV complications such as elevated MELD score or cirrhosis. Serious infection is rare and patients respond well to granulocyte colony-stimulating factor. Severely neutropenic patients with HCV appear to have a benign course and may be candidates for antiviral therapy.
authors.affiliation: Hematology Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Vivien
authors.initials: V
authors.lastname: Sheehan
authors.forename: Alva
authors.initials: A
authors.lastname: Weir
authors.forename: Bradford
authors.initials: B
authors.lastname: Waters
mesh_terms: D001741:Black or African American; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications* / Q000453:epidemiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013714:Tennessee / Q000453:epidemiology
chemical_list: D000998:Antiviral Agents