Changes in haemoglobin during interferon alpha-2b plus ribavirin combination therapy for chronic hepatitis C virus infection.
Changes in haemoglobin during interferon alpha-2b plus ribavirin combination therapy for chronic hepatitis C virus infection.
复制标题
干扰素α-2b加利巴韦林联合治疗慢性丙型肝炎病毒感染期间血红蛋白的变化。
DOI：
10.1111/j.1365-2893.2004.00490.x
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发表时间：
2004
期刊：
影响因子：
--
通讯作者：
Gish,R
中科院分区：
文献类型：
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作者：
Sulkowski,MS;Wasserman,R;Brooks,L;Ball,L;Gish,R
干扰素和利巴韦林(RBV)联合治疗与降低血红蛋白(Hb)浓度和贫血有关。这项分析的目的是更好地描述乙肝变化的大小和频率以及风险因素。这项回顾分析评估了参加两项针对慢性丙型肝炎病毒(丙型肝炎病毒)感染的干扰素α-2b加RBV研究之一的677名患者的与治疗相关的Hb变化。研究1包括192名干扰素初治患者，随机接受RBV1000-1200 mg/天加干扰素α-2b 300万 ，每天或每周三次，共48 周。研究2包括485名有α干扰素经验的患者，他们随机接受RBV1000-1200 mg每日加干扰素α-2b 300万 ，每天或每周3次，共4 周，然后每周3次，共44 周。超过50%的患者经历了Hb ≥30 g/L的下降，女性经历Hb水平下降到<；100 g/L的可能性是男性的4.4倍；而男性经历Hb水平从基线到>；30 g/L下降的风险高出40%。每日使用干扰素α-2b并不影响Hb下降的幅度。在这项综合分析中，减少RBV剂量导致Hb浓度增加约10 g/L。较低的基线肌酐清除量、较高的基线Hb水平和年龄增加与Hb风险增加27.7%独立相关。较低的基线体重与Hb降低的风险增加无关。在干扰素α/RBV联合治疗中，Hb显著降低的情况经常发生。在接受RBV治疗的患者中，性别、Hb下降的幅度和肾功能是潜在的重要因素。需要进一步的研究来确定对病毒学反应的影响，并制定管理医疗后果的策略。
Interferon alpha and ribavirin (RBV) combination therapy is associated with decreases in haemoglobin (Hb) concentrations and anaemia. The aim of this analysis was to better characterize the magnitude and frequency of Hb changes and risk factors. This retrospective analysis evaluated treatment‐related changes in Hb in 677 patients who participated in either of two interferon alpha‐2b plus RBV studies for chronic hepatitis C virus (HCV) infection. Study 1 included 192 interferon alpha‐naïve patients randomized to receive RBV 1000–1200 mg/day plus interferon alpha‐2b 3 million IU daily or three times weekly for 48 weeks. Study 2 included 485 interferon alpha‐experienced patients randomized to receive RBV 1000‐1200 mg daily plus interferon alpha‐2b 3 million IU daily or three times weekly for 4 weeks, followed by three times weekly dosing for 44 weeks. More than 50% of all patients experienced a decrease in Hb ≥30 g/L. Women were 4.4 times as likely as men to experience a Hb level of <100 g/L; however, men were at a 40% higher risk to experience a Hb decline of >30 g/L from baseline. Daily use of interferon alpha‐2b did not impact the magnitude of Hb decrease. In this pooled analysis, RBV dose reduction resulted in increases in Hb concentration of approximately 10 g/L. Lower baseline creatinine clearance, higher baseline Hb levels and increased age were independently associated with increased risk of Hb decreases of >27.7%. Lower baseline weight was not associated with increased risk of Hb decrease. Substantial Hb decreases occur frequently with interferon alpha/RBV combination therapy. Sex, the magnitude of the Hb decline and renal function are potentially important factors to consider in patients receiving RBV. Further research is needed to determine the impact on virological response and to develop strategies to manage the medical consequences.