Original paper
Haematological side effects in patients with chronic viral hepatitis C during treatment with alpha interferon and ribavirin

Introduction: Current antiviral treatment of chronic viral hepatitis type C is expensive, effective in approximately 50% of cases and has many side effects. Knowledge about pathogenesis of side effects of alpha interferon (IFN) and ribavirin (RBV) is needed to increase safety of this therapy. Haematological complications in patients treated with IFN and RBV are the most frequent reasons for dose reduction or discontinuation of therapy.
The aim of the study was to evaluate haematological disturbances as well as factors influencing risk of developing them during treatment with IFN and RBV.
Material and methods: 46 patients with chronic viral hepatitis type C treated with pegylated alpha 2a IFN and RBV were studied. We evaluated blood cell counts every month of treatment, and also severity of liver fibrosis, genotype HCV, viral load, age, sex and body mass index.
Results: No significant relationship between all studied factors and changes in blood cell count was shown. It was found that treatment with IFN has various inhibitory effects on different leukocyte populations with inhibition of eosinophils and neutrophils, whereas lymphocytes and monocytes were less affected. No clinically significant complications related to neutropenia or thrombocytopenia were noted. In patients treated with IFN and RBV haemolytic megaloblastic anaemia was observed. Changes in leukocyte, erythrocyte and platelet counts reported in this study confirmed the previously published data.
Conclusions: Lack of clinical complications, despite observed neutropenia with relative lymphocytosis in studied patients, suggests a change in currently recommended IFN dose reduction. Further studies on pathogenesis of haemolytic anaemia with megaloblastic reaction are needed; they may enable development of its prophylaxis and increase treatment efficacy.