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Factors contributing to ribavirin-induced anemia.

AbstractBACKGROUND AND AIM: Interferon and ribavirin combination therapy for chronic hepatitis C produces hemolytic anemia. This study was conducted to identify the factors contributing to ribavirin-induced anemia. METHODS: Eighty-eight patients with chronic hepatitis C who received interferon-alpha-2b at a dose of 6 MU administered intramuscularly for 24 weeks in combination with ribavirin administered orally at a dose of 600 mg or 800 mg participated in the study. A hemoglobin concentration of <10 g/dL was defined as ribavirin-induced anemia. RESULTS: Ribavirin-induced anemia occurred in 18 (20.5%) patients during treatment. A 2 g/dL decrease in hemoglobin concentrations in patients with anemia was observed at week 2 after the start of treatment. The hemoglobin concentration in patients with > or =2 g/dL decrease at week 2 was observed to be significantly lower even after week 2 than in patients with <2 g/dL decrease (P < 0.01). A significant relationship was observed between the rate of reduction of hemoglobin concentrations at week 2 and the severity of anemia (P < 0.01). Such factors as sex (female), age (> or =60 years old), and the ribavirin dose by body weight (12 mg/kg or more) were significant by univariate analysis. CONCLUSIONS: Careful administration is necessary in patients > or =60 years old, in female patients, and in patients receiving a ribavirin dose of 12 mg/kg or more. Patients who experience a fall in hemoglobin concentrations of 2 g/dL or more at week 2 after the start of treatment should be monitored with particular care.
AuthorsHideyuki Nomura, Hironori Tanimoto, Eiji Kajiwara, Junya Shimono, Toshihiro Maruyama, Nobuyuki Yamashita, Masanori Nagano, Masashi Higashi, Tamotsu Mukai, Yutaka Matsui, Jun Hayashi, Seizaburo Kashiwagi, Hiromi Ishibashi (Affiliation: Department of Internal Medicine, Shin-Kokura Hospital, Kitakyushu, Fukuoka, Japan. h-nomura at shin-kokura.gr.jp)
JournalJournal of gastroenterology and hepatology (J Gastroenterol Hepatol) Vol. 19 Issue 11 Pg. 1312-7 (Nov 2004) ISSN: 0815-9319 Australia
PMID15482540 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Antiviral Agents
  • Hemoglobins
  • Ribavirin
  • Interferon Alfa-2b
Topics
  • Adult
  • Aged
  • Anemia, Hemolytic (chemically induced)
  • Antiviral Agents (administration & dosage, adverse effects)
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Hemoglobins (metabolism)
  • Hepatitis C, Chronic (drug therapy)
  • Humans
  • Interferon Alfa-2b (administration & dosage)
  • Male
  • Middle Aged
  • Ribavirin (administration & dosage, adverse effects)
  • Risk Factors