title: Incidence and predictors of hematological side effects in chronic HCV Egyptian patients treated with PEGylated interferon and ribavirin.
abstract: OBJECTIVE
  The aim of this paper was to study the incidence and predictors of hematological abnormalities during treatment of chronic hepatitis C virus (HCV) patients with interferon and ribavirin.
  
  
  METHODS
  One thousand and eighty-one chronic HCV patients who were treated with PEGylated interferon α-2a 180 μg (n = 536) or α-2b 1.5 μg/kg (n = 545) plus ribavirin for 48 weeks were included. Baseline demographic, laboratory, and histopathological data and, during treatment, hematological data were collected and analyzed using univariate and multivariate analyses to identify independent predictors of hematological side effects.
  
  
  RESULTS
  During therapy, 168 of 1,018 (15.5 %) had moderate anemia (Hb <10 and ≥8.5 g/dL) and 88 (8.1 %) had severe anemia (Hb <8.5 g/dL). Two hundred and six patients (19.1 %) had moderate neutropenia (absolute neutrophil count (ANC) <750 and ≥500/mm(3)); only 55 (5.1 %) had severe neutropenia (ANC <500/mm(3)). Forty-three patients (4 %) had moderate (platelet <50,000 and ≥25,000/mm(3)) and 5 (1.4 %) had severe thrombocytopenia (platelet <25,000/mm(3)). Fibrosis stage, week 4 Hb level, and week 2 and 4 reduction level in Hb were independent predictors of moderate and severe anemia (p < 0.001). Fibrosis stage and ANC at weeks 2 and 4 were predictors of neutropenia (p < 0.001, 0.001, and 0.004, respectively). Fibrosis stage and platelet count at weeks 2 and 4 were predictors of thrombocytopenia (p < 0.001, <0.001, and 0.005, respectively). There was no association between interferon type and anemia (p = 0.57), neutropenia (p = 0.6), or thrombocytopenia (p = 0.79).
  
  
  CONCLUSIONS
  Fibrosis stage and week 2 and 4 hematological parameter reduction levels were independent predictors of hematological side effects, which are not related to interferon type.
authors.affiliation: Hepatology, Gastroenterology, and Infectious Diseases Department, Benha University, Benha, PO Box 31518, Qualubia, Egypt.
authors.forename: A H
authors.initials: AH
authors.lastname: Lashin
authors.forename: Y A
authors.initials: YA
authors.lastname: Shaheen
authors.forename: M A
authors.initials: MA
authors.lastname: Metwally
authors.forename: H M
authors.initials: HM
authors.lastname: El-Feky
authors.forename: M F
authors.initials: MF
authors.lastname: Hegab
authors.forename: S M
authors.initials: SM
authors.lastname: Abbas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000740:Anemia / Q000139:chemically induced; D000998:Antiviral Agents / Q000009:adverse effects*; D004359:Drug Therapy, Combination / Q000009:adverse effects; D004534:Egypt; D005260:Female; D006402:Hematologic Diseases / Q000139:chemically induced*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects*; D007958:Leukocyte Count; D008103:Liver Cirrhosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D009504:Neutrophils; D010976:Platelet Count; D011092:Polyethylene Glycols / Q000009:adverse effects*; D011237:Predictive Value of Tests; D011994:Recombinant Proteins / Q000009:adverse effects; D012254:Ribavirin / Q000009:adverse effects*; D013921:Thrombocytopenia / Q000139:chemically induced; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a