Aftab Ahmed Sheikh, Mona Humaira, Madiha Zaki, Mohammad Adnan Bawani, Sadik Memon.
Severity of Anemia during Interferon and Ribavirin Therapy in Patients with Chronic Active Hepatitis #C #Genotype-3 and its Association with Risk Factors.
J Liaquat Uni Med Health Sci Jan ;12(03):161-6.

Hepatitis C is a major public health problem globally. It is one of the commonest cause of chronic liver disease in Pakistan. The prevalent genotype is “3” in our country. The standard of care treatment is combination of interferon and ribavirin. This combination has important adverse effects especially hemolytic anemia. AIMS & OBJECTIVES: This study has been conducted to determine the frequency of anemia (< 10gm/dl) at 4, 12 and 24 weeks of interferon and ribavirin treatment CAH-C Genotype-3patients along with assessment of associated risk factors. PLACE AND DURATION: This study was conducted in department of Gastroenterology & Hepatology, Isra University Hospital, Hyderabad, Sindh from April 2009 to October 2010. STUDY DESIGN: Prospective & case series study MATERIALS AND METHODS: All patients who fulfilled the inclusion and exclusion criteria were enrolled. The proforma was filled after patients verbal consent, by asking questions .Their BMI was recorded and other demographic characteristics were also noted .Patients were followed at 4,8,12,16,20 and 24 week. Their Blood CP was checked and if Hb fall within the range of 10.1 - 11.9 mg/dL then the dose of ribavirin was reduced (200 mg/day reduction) and if Hb was <8.5 g/dL then both drugs were stopped altogether. RESULTS: A total of 140 patients were remained for final analysis. Male were 73(52%, n = 140). Only 18(13%, n = 140) patients developed anemia at week 4 of treatment. Compared to baseline mean Hb% SD 13.31+1.18 (12 to 17 gm/dl), week 4 post treatment mean Hb +SD (Range) was 11.2 + 1.15(gm/dl. Almost 76.4% (107) of patients dropped hemoglobin more than two grams at week 4 from baseline. The mean Hb% level at week 12 of treatment was 11.2 gm/dl. There were 31 (22%) patients developed anemia Hb<10.0 gm/dL .It was significantly seen in females. One hundred and seven (76.4%) patients dropped Hb more than 2 gm at week 12. Total of 30 (18%) patients developed anemia (Hb<10.0 gm/dL) at week 24. Mean hemoglobin level at week 24 was 11.1 gm/dl. Anemia at week 4 & 12 were the two strong predicators of anemia at week 24. Other significant factors associated with anemia at week 24, were female sex and body weight less than 60kg at baseline. CONCLUSION: Anemia is a frequent complication of Anti HCV therapy.

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