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Early Predictors of Anemia in Patients With Hepatitis C Genotype 1 Treated With Peginterferon Alfa-2a (40KD) Plus Ribavirin
- Source :
- The American Journal of Gastroenterology. 103:1981-1988
- Publication Year :
- 2008
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2008.
-
Abstract
- Adherence to ribavirin is one factor that is critically important in the treatment of hepatitis C virus infection. However, ribavirin can be associated with clinically significant hemolytic anemia resulting in dose modifications in up to one-quarter of patients. Currently, baseline predictors of considerable anemia are not sufficiently discriminating for routine therapeutic intervention. The objective of this analysis was to elucidate baseline and on-treatment factors predictive of a considerable hemoglobin drop at week 4.Multivariate logistic regression analysis was used to explore possible predictors for considerable hemoglobin decline (or =2.5 g/dL) at week 4 among patients receiving peginterferon alfa-2a (40KD) and ribavirin (1,000/1,200 mg/day).A total of 555 patients were included in this analysis. At week 4, 236 patients exhibited aor =2.5 g/dL decrease in hemoglobin. By regression analysis the most important independent variables associated with a decrease in hemoglobin ofor =2.5 g/dL were baseline creatinine clearance (P= 0.0003) and a rapid decline in hemoglobin ofor =1.5 g/dL at week 2 (P0.0001). Considerable hemoglobin decreases at week 4 were also significantly associated with early ribavirin dose reductions and a lower cumulative daily dose of ribavirin.Patients with impaired renal function may be at an increased risk of ribavirin-related anemia and should be monitored accordingly. Furthermore, a hemoglobin drop ofor =1.5 g/dL by week 2 was an excellent early predictor for subsequent considerable hemoglobin decreases and might be used to identify candidates for early intervention against anemia in order to help maintain ribavirin dosing and avoid suboptimal exposure.
- Subjects :
- Adult
Male
medicine.medical_specialty
Anemia
Alpha interferon
Interferon alpha-2
Antiviral Agents
Gastroenterology
Article
Polyethylene Glycols
Hemoglobins
chemistry.chemical_compound
stomatognathic system
Predictive Value of Tests
hemic and lymphatic diseases
Internal medicine
Ribavirin
Genotype
medicine
Humans
Prospective Studies
Prospective cohort study
Hepatology
business.industry
Interferon-alpha
virus diseases
Hepatitis C
Middle Aged
medicine.disease
Recombinant Proteins
digestive system diseases
Logistic Models
Treatment Outcome
chemistry
Immunology
Female
Viral disease
business
Follow-Up Studies
Peginterferon alfa-2a
medicine.drug
Subjects
Details
- ISSN :
- 15720241 and 00029270
- Volume :
- 103
- Database :
- OpenAIRE
- Journal :
- The American Journal of Gastroenterology
- Accession number :
- edsair.doi.dedup.....dfc1edc9dd1c7b13d1177b11f6cffe71