Virological response is associated with decline in hemoglobin concentration during pegylated interferon and ribavirin therapy in hepatitis C virus genotype 1

April 18, 2011

Hepatology. 2011 Apr;53(4):1109-1117. doi: 10.1002/hep.24180.

Virological response is associated with decline in hemoglobin concentration

during pegylated interferon and ribavirin therapy in hepatitis C virus genotype

1.

Sievert W, Dore GJ, McCaughan GW, Yoshihara M, Crawford DH, Cheng W, Weltman M,

Rawlinson W, Rizkalla B, Depamphilis JK, SK; on behalf of the CHARIOT

Study Group.

Gastroenterology and Hepatology Unit, Monash Medical Centre and Centre for

Inflammatory Diseases, Monash University, Melbourne, VIC, Australia.

william.sievert@....

Abstract

Anemia may increase the likelihood of achieving a sustained virological response

(SVR) during pegylated interferon and ribavirin treatment of hepatitis C virus

(HCV) infection. To determine whether hemoglobin decline is associated with SVR,

we retrospectively evaluated the CHARIOT study of 871 treatment-naïve HCV

genotype 1 patients. Anemia (serum hemoglobin <100 g/L) occurred in 137 (16%)

patients, of whom only 14 (10%) received erythropoietin. Hemoglobin decline

>30g/L from baseline occurred in 76% of patients overall, including 526 patients

who did not become anemic. Virological responses were higher in anemic patients

compared with those who did not develop anemia (end of treatment, 80% versus

65%, P = 0.003; SVR, 61% versus 50%, P = 0.02); these differences remained

significant when patients receiving erythropoietin were excluded from analysis.

SVR was also higher in patients with hemoglobin decline >30 g/L compared with

patients without a similar decline. In multiple logistic regression analyses

with treatment group and baseline characteristics, the odds ratio for SVR was

1.97 (95% confidence interval, 1.08-3.62) for anemia and 2.17 (95% confidence

interval, 1.31-3.62) for hemoglobin decline >30 g/L. Patients who first

developed a hemoglobin decline >30 g/L during weeks 5-12 and 13-48 were more

likely to achieve SVR than those who first developed such changes in weeks 0-4

or who never experienced them. Conclusion: Patients with HCV genotype 1

infection who develop anemia or experience a hemoglobin decline >30 g/L during

weeks 5-48 of therapy achieve higher virological responses to pegylated

interferon and ribavirin therapy that are unrelated to erythropoietin use.

(HEPATOLOGY 2011;).

PMID: 21480317 [PubMed - as supplied by publisher]

April 18, 2011