Feasibility of pegylated interferon and ribavirin in hepatitis C-related cirrhosis with neutropenia or thrombocytopenia

Angelo Iacobellis, Raffaele Cozzolongo, Nicola Minerva, Maria Rosa Valvano, Grazia Anna Niro, Rosanna Fontana, Orazio Palmieri, Antonio Ippolito, Angelo Andriulli

Research output: Contribution to journalArticle

Abstract

Aim: To investigate the feasibility of pegylated interferon plus ribavirin treatment in cirrhotic patients who presented with, or developed while on-treatment, platelet counts ≤80,000/μL and/or neutrophil counts ≤1500/μL. Methods: A retrospective analysis of prospectively gathered data on 123 cirrhotic patients treated with pegylated interferon and ribavirin. Adverse effects and haematological changes were monitored: bleeding and infectious events were registered and related to platelet and absolute neutrophil counts. Results: Among the 58 patients (47.2%) with nadir platelets ≤50,000/μL during therapy, 6 (10.3%) experienced a bleeding episode; of the remaining 65 patients with platelets constantly >50,000/μL, 3 (4.6%) bled. Of the 11 bleedings, 3 manifested during an infection, while patients had platelets >50,000/μL. Nadir neutrophils ≤750/μL occurred in 45 patients (38.2%) during treatment, and 14 of them (29.8%) had an infectious event. Infections were also documented in 18 of the 76 patients (23.7%) with neutrophils constantly >750/μL. Conclusions: The study reveals the feasibility of treating cirrhotic patients with cytopenia with pegylated interferon and ribavirin, as bleeding or infectious events under therapy were unrelated to platelet and neutrophil counts. Withdrawal of therapy or variations in the pre-assigned dosages of either pegylated interferon or ribavirin owing to abnormally low haematological parameters seems to no longer be tenable.

Original languageEnglish
Pages (from-to)621-624
Number of pages4
JournalDigestive and Liver Disease
Volume46
Issue number7
DOIs
Publication statusPublished - 2014

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Keywords

  • Antiviral treatment
  • Bleeding
  • HCV
  • Infections
  • Liver cirrhosis
  • Neutrophils
  • Platelets

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology
  • Medicine(all)

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