Peripheral blood cytopaenia limiting initiation of treatment in chronic hepatitis C patients otherwise eligible for antiviral therapy
Article first published online: 4 APR 2012
© 2012 John Wiley & Sons A/S
Volume 32, Issue 7, pages 1113–1119, August 2012
How to Cite
Giannini, E. G., Marenco, S., Fazio, V., Pieri, G., Savarino, V. and Picciotto, A. (2012), Peripheral blood cytopaenia limiting initiation of treatment in chronic hepatitis C patients otherwise eligible for antiviral therapy. Liver International, 32: 1113–1119. doi: 10.1111/j.1478-3231.2012.02798.x
- Issue published online: 2 JUL 2012
- Article first published online: 4 APR 2012
- Manuscript Accepted: 5 MAR 2012
- Manuscript Received: 17 DEC 2011
- Hoffman LaRoche
- Merck. A. Picciotto
- Hepatitis C virus;
- pegylated interferon;
In patients with chronic hepatitis C virus (HCV) infection, the presence of peripheral blood cytopaenia may represent an obstacle to pegylated interferon and ribavirin treatment.
To evaluate the prevalence of anaemia, neutropaenia and thrombocytopaenia potentially limiting initiation of pegylated interferon and ribavirin treatment in patients with chronic HCV infection who were otherwise eligible for antiviral therapy.
We studied 3059 consecutive anti-HCV and HCV-RNA positive patients referred to our centre to be evaluated for antiviral therapy from June 2002 to May 2011. The European Association for the Study of Liver HCV guidelines were applied to assess eligibility for antiviral therapy.
In the study cohort, 1,521 patients (49.7%) were not eligible for treatment because of reasons different from haematological abnormalities. In the remaining 1,538 patients the overall prevalence of any peripheral blood cytopaenia potentially preventing patients from being treated with antiviral therapy was 15.1%. In particular, anaemia (haemoglobin level < 12 g/dL for women, <13 g/dL for men) was a relative contraindication to treatment in 8.9% (137/1,538) of the patients, while thrombocytopaenia (platelet count cut-off, 90 × 109/L) and neutropaenia (absolute neutrophil count < 1.5 × 109/L) limited treatment in 6.5% (100/1358) and 3.2% (48/1358) of patients respectively. These haematological abnormalities were more prevalent in patients with older age (P < 0.004) and cirrhosis (P < 0.001).
The presence of peripheral blood cytopaenia may potentially limit initiation of antiviral therapy in one in every seven patients with chronic HCV infection who are otherwise eligible for treatment.