Peripheral blood cytopaenia limiting initiation of treatment in chronic hepatitis C patients otherwise eligible for antiviral therapy
Liver International, 07/16/2012
Giannini EG et al. – The presence of peripheral blood cytopaenia may potentially limit initiation of antiviral therapy in one in every seven patients with chronic hepatitis C virus infection who are otherwise eligible for treatment.Methods
- The authors studied 3059 consecutive anti-HCV and HCV-RNA positive patients referred to the centre to be evaluated for antiviral therapy from June 2002 to May 2011.
- The European Association for the Study of Liver HCV guidelines were applied to assess eligibility for antiviral therapy.
- In the study cohort, 1,521 patients (49.7%) were not eligible for treatment because of reasons different from haematological abnormalities.
- In the remaining 1,538 patients the overall prevalence of any peripheral blood cytopaenia potentially preventing patients from being treated with antiviral therapy was 15.1%.
- In particular, anaemia (haemoglobin level < 12 g/dL for women, <13 g/dL for men) was a relative contraindication to treatment in 8.9% (137/1,538) of the patients, while thrombocytopaenia (platelet count cut-off, 90 × 109/L) and neutropaenia (absolute neutrophil count < 1.5 × 109/L) limited treatment in 6.5% (100/1358) and 3.2% (48/1358) of patients respectively.
- These haematological abnormalities were more prevalent in patients with older age (P < 0.004) and cirrhosis (P < 0.001).