Factors contributing to ribavirin-induced anemia.

Abstract

BACKGROUND 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.

• Authors: Hideyuki 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
• Journal: Journal of gastroenterology and hepatology (J Gastroenterol Hepatol) Vol. 19 Issue 11 Pg. 1312-7 (Nov 2004) ISSN: 0815-9319 [Print] Australia
• PMID: 15482540 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antiviral Agents
• Hemoglobins
• Interferon alpha-2
• Interferon-alpha
• Recombinant Proteins
• Ribavirin

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 alpha-2
• Interferon-alpha (administration & dosage)
• Male
• Middle Aged
• Recombinant Proteins
• Ribavirin (administration & dosage, adverse effects)
• Risk Factors