Erythropoietic response to anemia in chronic hepatitis C patients receiving combination pegylated interferon/ribavirin

Vijayan Balan, David Schwartz, George Y. Wu, Andrew J. Muir, Reem Ghalib, John Jackson, Emmet B. Keeffe, Lorenzo Rossaro, Alfreda Burnett, Betty L. Goon, Peter J. Bowers, Gerhard J. Leitz

Research output: Contribution to journalArticle

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Abstract

OBJECTIVES: In hepatitis C virus (HCV)-infected patients receiving pegylated interferon (PEG-IFN)/ribavirin (RBV) combination therapy, anemia is a well-known side effect. The purpose of this study was to describe the time course and extent of hemoglobin (Hb) changes and the erythropoietic response to PEG-IFN/RBV-induced anemia. METHODS: In this multicenter, observational, 8-wk study, laboratory parameters were measured weekly for 8 wk or until early withdrawal. Primary endpoints included changes in Hb and serum erythropoietin (sEPO) from baseline to week 8; other measures were changes in reticulocytes and RBV dose. The predictive value of baseline factors for maximum Hb decline was assessed. RESULTS: In the 97 evaluable patients, mean Hb decreased from 14.4 ± 1.4 g/dl (baseline) to 11.9 ± 1.3 g/dl (week 8). Twenty-one percent of patients withdrew before week 8. The estimated erythropoietic response was lower than that seen in two historic control populations of iron deficiency anemia patients. Mean RBV dose decreased from 986 ± 190 mg/day (baseline) to 913 ± 228 mg/day (week 8). Fifty-seven out of 77 (74%) patients who completed the study maintained their initial prescribed RBV dose. Patients maintained on the initial dose of RBV who had a higher baseline Hb and viral load showed a trend toward larger Hb declines. Platelets and white blood cells (WBCs) also declined during the study. CONCLUSIONS: HCV-infected patients receiving PEG-IFN/RBV therapy have reductions in Hb, platelets, and WBCs, possibly due to bone marrow suppression. They also have diminished endogenous sEPO production for their degree of anemia.

Original languageEnglish (US)
Pages (from-to)299-307
Number of pages9
JournalAmerican Journal of Gastroenterology
Volume100
Issue number2
DOIs
StatePublished - Feb 2005
Externally publishedYes

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Ribavirin
Chronic Hepatitis C
Interferons
Anemia
Hemoglobins
Erythropoietin
Hepacivirus
Leukocytes
Blood Platelets
Iron-Deficiency Anemias
Reticulocytes
Viral Load
Serum
Bone Marrow
Therapeutics
Population

ASJC Scopus subject areas

  • Gastroenterology

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Erythropoietic response to anemia in chronic hepatitis C patients receiving combination pegylated interferon/ribavirin. / Balan, Vijayan; Schwartz, David; Wu, George Y.; Muir, Andrew J.; Ghalib, Reem; Jackson, John; Keeffe, Emmet B.; Rossaro, Lorenzo; Burnett, Alfreda; Goon, Betty L.; Bowers, Peter J.; Leitz, Gerhard J.

In: American Journal of Gastroenterology, Vol. 100, No. 2, 02.2005, p. 299-307.

Research output: Contribution to journalArticle

Balan, V, Schwartz, D, Wu, GY, Muir, AJ, Ghalib, R, Jackson, J, Keeffe, EB, Rossaro, L, Burnett, A, Goon, BL, Bowers, PJ & Leitz, GJ 2005, 'Erythropoietic response to anemia in chronic hepatitis C patients receiving combination pegylated interferon/ribavirin', American Journal of Gastroenterology, vol. 100, no. 2, pp. 299-307. https://doi.org/10.1111/j.1572-0241.2005.40757.x
Balan, Vijayan ; Schwartz, David ; Wu, George Y. ; Muir, Andrew J. ; Ghalib, Reem ; Jackson, John ; Keeffe, Emmet B. ; Rossaro, Lorenzo ; Burnett, Alfreda ; Goon, Betty L. ; Bowers, Peter J. ; Leitz, Gerhard J. / Erythropoietic response to anemia in chronic hepatitis C patients receiving combination pegylated interferon/ribavirin. In: American Journal of Gastroenterology. 2005 ; Vol. 100, No. 2. pp. 299-307.
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abstract = "OBJECTIVES: In hepatitis C virus (HCV)-infected patients receiving pegylated interferon (PEG-IFN)/ribavirin (RBV) combination therapy, anemia is a well-known side effect. The purpose of this study was to describe the time course and extent of hemoglobin (Hb) changes and the erythropoietic response to PEG-IFN/RBV-induced anemia. METHODS: In this multicenter, observational, 8-wk study, laboratory parameters were measured weekly for 8 wk or until early withdrawal. Primary endpoints included changes in Hb and serum erythropoietin (sEPO) from baseline to week 8; other measures were changes in reticulocytes and RBV dose. The predictive value of baseline factors for maximum Hb decline was assessed. RESULTS: In the 97 evaluable patients, mean Hb decreased from 14.4 ± 1.4 g/dl (baseline) to 11.9 ± 1.3 g/dl (week 8). Twenty-one percent of patients withdrew before week 8. The estimated erythropoietic response was lower than that seen in two historic control populations of iron deficiency anemia patients. Mean RBV dose decreased from 986 ± 190 mg/day (baseline) to 913 ± 228 mg/day (week 8). Fifty-seven out of 77 (74{\%}) patients who completed the study maintained their initial prescribed RBV dose. Patients maintained on the initial dose of RBV who had a higher baseline Hb and viral load showed a trend toward larger Hb declines. Platelets and white blood cells (WBCs) also declined during the study. CONCLUSIONS: HCV-infected patients receiving PEG-IFN/RBV therapy have reductions in Hb, platelets, and WBCs, possibly due to bone marrow suppression. They also have diminished endogenous sEPO production for their degree of anemia.",
author = "Vijayan Balan and David Schwartz and Wu, {George Y.} and Muir, {Andrew J.} and Reem Ghalib and John Jackson and Keeffe, {Emmet B.} and Lorenzo Rossaro and Alfreda Burnett and Goon, {Betty L.} and Bowers, {Peter J.} and Leitz, {Gerhard J.}",
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T1 - Erythropoietic response to anemia in chronic hepatitis C patients receiving combination pegylated interferon/ribavirin

AU - Balan, Vijayan

AU - Schwartz, David

AU - Wu, George Y.

AU - Muir, Andrew J.

AU - Ghalib, Reem

AU - Jackson, John

AU - Keeffe, Emmet B.

AU - Rossaro, Lorenzo

AU - Burnett, Alfreda

AU - Goon, Betty L.

AU - Bowers, Peter J.

AU - Leitz, Gerhard J.

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Y1 - 2005/2

N2 - OBJECTIVES: In hepatitis C virus (HCV)-infected patients receiving pegylated interferon (PEG-IFN)/ribavirin (RBV) combination therapy, anemia is a well-known side effect. The purpose of this study was to describe the time course and extent of hemoglobin (Hb) changes and the erythropoietic response to PEG-IFN/RBV-induced anemia. METHODS: In this multicenter, observational, 8-wk study, laboratory parameters were measured weekly for 8 wk or until early withdrawal. Primary endpoints included changes in Hb and serum erythropoietin (sEPO) from baseline to week 8; other measures were changes in reticulocytes and RBV dose. The predictive value of baseline factors for maximum Hb decline was assessed. RESULTS: In the 97 evaluable patients, mean Hb decreased from 14.4 ± 1.4 g/dl (baseline) to 11.9 ± 1.3 g/dl (week 8). Twenty-one percent of patients withdrew before week 8. The estimated erythropoietic response was lower than that seen in two historic control populations of iron deficiency anemia patients. Mean RBV dose decreased from 986 ± 190 mg/day (baseline) to 913 ± 228 mg/day (week 8). Fifty-seven out of 77 (74%) patients who completed the study maintained their initial prescribed RBV dose. Patients maintained on the initial dose of RBV who had a higher baseline Hb and viral load showed a trend toward larger Hb declines. Platelets and white blood cells (WBCs) also declined during the study. CONCLUSIONS: HCV-infected patients receiving PEG-IFN/RBV therapy have reductions in Hb, platelets, and WBCs, possibly due to bone marrow suppression. They also have diminished endogenous sEPO production for their degree of anemia.

AB - OBJECTIVES: In hepatitis C virus (HCV)-infected patients receiving pegylated interferon (PEG-IFN)/ribavirin (RBV) combination therapy, anemia is a well-known side effect. The purpose of this study was to describe the time course and extent of hemoglobin (Hb) changes and the erythropoietic response to PEG-IFN/RBV-induced anemia. METHODS: In this multicenter, observational, 8-wk study, laboratory parameters were measured weekly for 8 wk or until early withdrawal. Primary endpoints included changes in Hb and serum erythropoietin (sEPO) from baseline to week 8; other measures were changes in reticulocytes and RBV dose. The predictive value of baseline factors for maximum Hb decline was assessed. RESULTS: In the 97 evaluable patients, mean Hb decreased from 14.4 ± 1.4 g/dl (baseline) to 11.9 ± 1.3 g/dl (week 8). Twenty-one percent of patients withdrew before week 8. The estimated erythropoietic response was lower than that seen in two historic control populations of iron deficiency anemia patients. Mean RBV dose decreased from 986 ± 190 mg/day (baseline) to 913 ± 228 mg/day (week 8). Fifty-seven out of 77 (74%) patients who completed the study maintained their initial prescribed RBV dose. Patients maintained on the initial dose of RBV who had a higher baseline Hb and viral load showed a trend toward larger Hb declines. Platelets and white blood cells (WBCs) also declined during the study. CONCLUSIONS: HCV-infected patients receiving PEG-IFN/RBV therapy have reductions in Hb, platelets, and WBCs, possibly due to bone marrow suppression. They also have diminished endogenous sEPO production for their degree of anemia.

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