Bacterial infection and neutropenia during peginterferon plus ribavirin combination therapy in patients with chronic hepatitis C with and without baseline neutropenia in clinical practice
Article first published online: 7 FEB 2009
© 2009 The Author(s). Journal compilation © 2009 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 29, Issue 9, pages 1000–1010, May 2009
How to Cite
YANG, J.-F., HSIEH, M.-Y., HOU, N.-J., DAI, C.-Y., HUANG, J.-F., LIN, Z.-Y., CHEN, S.-C., HSIEH, M.-Y., WANG, L.-Y., CHUANG, W.-L. and YU, M.-L. (2009), Bacterial infection and neutropenia during peginterferon plus ribavirin combination therapy in patients with chronic hepatitis C with and without baseline neutropenia in clinical practice. Alimentary Pharmacology & Therapeutics, 29: 1000–1010. doi: 10.1111/j.1365-2036.2009.03957.x
- Issue published online: 1 APR 2009
- Article first published online: 7 FEB 2009
- Publication data Submitted 11 October 2008 First decision 17 November 2008 Resubmitted 9 January 2009 Accepted 3 February 2009 Epub Accepted Article 7 February 2009
Background Peginterferon-α–based therapy frequently leads to neutropenia. It remains unclear whether neutropenia is associated with bacterial infection in chronic hepatitis C (CHC).
Aim To evaluate the risk of bacterial infection and neutropenia in patients with CHC treated with peginterferon-α/ribavirin.
Methods In all, 207 patients with CHC with (group A, n = 30) and without (group B, n = 177) baseline neutropenia were treated with peginterferon-α/ribavirin.
Results Group A had significantly higher rates of moderate (<750 cells/μL) and severe (<500 cells/μL) neutropenia than group B (70.0% and 26.7% vs. 20.3% and 8.5% respectively, both P < 0.0001). The sustained virological response rate was similar between patients with and without neutropenia, at baseline or during treatment. Bacterial infection occurred in 4.3% of patients. Group A and patients with lower baseline neutrophil counts had substantially higher rates of bacterial infection. Patients with cirrhosis had significantly higher rates of infection during combination therapy than those without cirrhosis (15%, 3 of 20 vs. 3.2%, 6 of 187, P = 0.045). Nadir neutrophil counts were not correlated to infection episodes.
Conclusions Bacterial infection during peginterferon-based therapy for CHC was associated with comorbidity of cirrhosis, but not with neutropenia, whether at baseline or during treatment. Neutropenic CHC patients might be treated safely with close monitoring.