DOES HEPATITIS C (HCV) TREATMENT - RELATED ANEMIA PREDICT A GOOD RESPONSE?
HCV Treatment – Related Anaemia
Objective: To determine if HCV treatment-related anaemia is associated with a better response to combination therapy with conventional interferon and ribavirin.
Study Design: A descriptive cross sectional study.
Place and Duration of Study: Pakistan Rangers Hospital, Lahore from December 2010 to November 2012.
Material and Methods: Two hundred thirty eight treatment naïve consecutive hepatitis C Virus (HCV) infected patients were enrolled by non-probability purposive sampling. Baseline labs included complete blood count and peripheral blood film, Alanine aminotransferase (ALT), hepatitis C Virus (HCV) ribonucleic acid (RNA) by qualitative polymerase chain reaction (PCR). All patients received combination treatment with standard interferon and ribavirin according to Pakistan Society of Gastroenterology (PSG) guidelines 2009 for 24 weeks. Complete blood counts and ALT were measured at weeks 2 and 4 and then every 4 weeks during treatment. Qualitative PCR for HCV RNA was repeated at the end of 24 weeks treatment. Chi square test was used to compare patients for anaemia and End of treatment response (ETR).
Results: Out of 238 patients enrolled initially, 213 patients completed treatment while 25 were lost to follow up (not because of treatment withdrawal). Mean age was 36 years. Of these 207 were male and 6 were female. Mean hemoglobin (Hb) at baseline was 14.72g/dl (SD +1.24) and after 12 weeks 12.3 g/dl (SD +1.53). Anaemia was noted in 127 (59%) patients. ETR was achieved by 155 (72.8%). Seventy eight percent patients with anaemia achieved end of treatment response (ETR) while only 64% of those without anaemia achieved this response (p=0.017). Development of early anaemia was associated with greater response rates as compared to late onset anaemia but this difference was not statistically significant (p=0.88).
Conclusion: Anaemia due to HCV treatment with conventional interferon and ribavirin is associated with a significantly better ETR.