BACKGROUND: Peginterferon-alpha-based therapy frequently leads to neutropenia. It remains unclear whether neutropenia is associated with bacterial infection in chronic hepatitis C (CHC). AIM: To evaluate the risk of bacterial infection and neutropenia in patients with CHC treated with peginterferon-alpha/ribavirin. METHODS: In all, 207 patients with CHC with (group A, n = 30) and without (group B, n = 177) baseline neutropenia were treated with peginterferon-alpha/ribavirin. RESULTS: Group A had significantly higher rates of moderate (<750 cells/microL) and severe (<500 cells/microL) neutropenia than group B (70.0% and 26.7% vs. 20.3% and 8.5% respectively, both P < 0.0001). The sustained virological response rate was similar between patients with and without neutropenia, at baseline or during treatment. Bacterial infection occurred in 4.3% of patients. Group A and patients with lower baseline neutrophil counts had substantially higher rates of bacterial infection. Patients with cirrhosis had significantly higher rates of infection during combination therapy than those without cirrhosis (15%, 3 of 20 vs. 3.2%, 6 of 187, P = 0.045). Nadir neutrophil counts were not correlated to infection episodes. CONCLUSIONS: Bacterial infection during peginterferon-based therapy for CHC was associated with comorbidity of cirrhosis, but not with neutropenia, whether at baseline or during treatment. Neutropenic CHC patients might be treated safely with close monitoring.
BACKGROUND: Peginterferon-alpha-based therapy frequently leads to neutropenia. It remains unclear whether neutropenia is associated with bacterial infection in chronic hepatitis C (CHC). AIM: To evaluate the risk of bacterial infection and neutropenia in patients with CHC treated with peginterferon-alpha/ribavirin. METHODS: In all, 207 patients with CHC with (group A, n = 30) and without (group B, n = 177) baseline neutropenia were treated with peginterferon-alpha/ribavirin. RESULTS: Group A had significantly higher rates of moderate (<750 cells/microL) and severe (<500 cells/microL) neutropenia than group B (70.0% and 26.7% vs. 20.3% and 8.5% respectively, both P < 0.0001). The sustained virological response rate was similar between patients with and without neutropenia, at baseline or during treatment. Bacterial infection occurred in 4.3% of patients. Group A and patients with lower baseline neutrophil counts had substantially higher rates of bacterial infection. Patients with cirrhosis had significantly higher rates of infection during combination therapy than those without cirrhosis (15%, 3 of 20 vs. 3.2%, 6 of 187, P = 0.045). Nadir neutrophil counts were not correlated to infection episodes. CONCLUSIONS:Bacterial infection during peginterferon-based therapy for CHC was associated with comorbidity of cirrhosis, but not with neutropenia, whether at baseline or during treatment. Neutropenic CHCpatients might be treated safely with close monitoring.
Authors: Michael T Melia; Norbert Bräu; Fred Poordad; Eric J Lawitz; Mitchell L Shiffman; John G McHutchison; Andrew J Muir; Greg W Galler; Lisa M Nyberg; William M Lee; Eugene Schiff; Jianmin Long; Stephanie Noviello; Clifford A Brass; Lisa D Pedicone; Mark S Sulkowski Journal: Clin Infect Dis Date: 2014-01-06 Impact factor: 9.079
Authors: Mark S Sulkowski; Curtis Cooper; Bela Hunyady; Jidong Jia; Pavel Ogurtsov; Markus Peck-Radosavljevic; Mitchell L Shiffman; Cihan Yurdaydin; Olav Dalgard Journal: Nat Rev Gastroenterol Hepatol Date: 2011-03-08 Impact factor: 46.802
Authors: Manuel Hernández-Guerra; Yanira González-Méndez; Patricia de Molina; Antonio Z Gimeno-García; Marta Carrillo; Carlos Casanova; Tomás Pumarola; Alejandro Jimenez; Miriam Hernández-Porto; Alvaro Torres; Enrique Quintero Journal: PLoS One Date: 2012-11-08 Impact factor: 3.240