干扰素α-2b联合利巴韦林治疗后慢性丙型肝炎患者外周血细胞数量的变化及其临床意义

doi:10.13481/j.1671-587x.20150332

Abstract

Abstract:

Objective To explore the changes in the number of peripheral blood cells in the patients with chronic hepatitis C(CHC) after treated with interferon alpha 2b(IFN-α2b) combined with ribavirin, and to clarify the impact factors of the number of peripheral blood cells. Methods A total of 343 CHC patients with symptoms of chronic hepatitis and positive anti -HCV and HCV RNA were selected.All patients received IFN-α2b (5 000 000 U, every other day, subcutaneous)combined with ribavirin (15 mg·kg^-1·d^-1, oral)for 48 weeks.The number of peripheral blood cells and serum HCV RNA level were assessed at 12, 24, 36, 48, 60, 72, and 96 weeks.The patients who developed neutropenia, anemia and thrombocytopenia would be treated according to "2010 Hepatitis C Treatment Guidelines". Results The prevalence of neutropenia, anemia and thrombocytopenia were 40.5%(139), 48.4%(166) and 39.9%(137), respectively.There were changes in the number of peripheral blood cells of individual patients after treatment.The most of changes occured from the beginning to 12 weeks.The number of neutrophils, hemoglobin and plateletsin were significantly decreased in 2 weeks, while the minimum value appeared at the 12th weeks followed by a slow rise.At the end of treatment (48 weeks), although the recovery was obvious, but not yet reached the pre-treatment levels.They recoved to the pre-treatment levels at 60 to 72 weeks.The baseline of absolute neutrophil count(ANC), plateletsin(PLT), aspartate transaminase(AST), alanine transaminase(ALT) and liver fibrosis were associated with neutropenia (P<0.05).The gender and baseline of hemoglobin levels were related to anemia(P<0.05).Gender, baseline of ANC, PLT, AST, ALT, γ-glutamyl transferase (γ-GT) and liver fibrosis were associated with thrombocytopenia(P<0.05). Conclusion The number of peripheral blood cells is significantly decreased in 2 weeks after anti-virus therapy, and reaches a minimum at 12 weeks, which reminds that clinicians should perform intervention and follow up timely to avoid serious adverse events.The occurrence and severity of reduction in the number of peripheral blood cells could be assessed according to the baseline gender, level of peripheral blood cells, liver function and liver fibrosis.

Key words: interferon alpha 2b, ribavirin, chronic hepatitis C, peripheral blood cells

CLC Number:

R575.1

MA Linyuan, ZHANG Peng, CHEN Qian, KONG Wenli, YANG Yiliang, LI Yuxiang, PAN Yu. Changes in number of peripheral blood cells in patients with chronic hepatitis C after treated with interferon alpha 2b combined with ribavirin and their clinical significances[J].Journal of Jilin University Medicine Edition, 2015, 41(03): 599-605.

References

[1] Su YY, Liu HX, Wang N.Hepatitis C virus genotypes in China:a systematic review[J].Zhonghua Liu Xing Bing Xue Za Zhi, 2013, 34(1):80-84.

[2] Naderi M, Gholiopour N, Zolfaqhari MR, et al.Hepatitis C virus and vaccine development[J].Int J Mol Cell Med, 2014, 3(4):207-215.

[3] Aqnesod D, De Nicolo A, Simiele M, et al.Development and validation of a useful UPLC-MS/MS method for quantification of total and phosphorylatedribavirin in peripheral blood mononuclear cells of HCV⁺ patients[J].Pharm Biomed Anal, 2014, 90(5):119-126.

[4] Hirakawa M, Ikeda K, Arase Y, et al.Hepatocarcinogenesis following HCV RNA eradication by interferon in chronic hepatitis patients[J].Int Med (Tokyo, Japan), 2007, 47(19):1637-1643.

[5] Fernández-Rodríguez CM, Alonso S, Martinez SM, et al.Peginterferon plus ribavirin and sustained virological response in HCV-related cirrhosis:outcomes and factors predicting response[J].Ame J Gastroenterol, 2010, 105(10):2164-2172.

[6] Oze T, Hiramatsu N, Yakushijin T, et al.Pegylated interferon alpha-2b (Peg-IFN α-2b) affects early virologic response dose-dependently in patients with chronic hepatitis C genotype 1 during treatment with Peg-IFN α-2b plus ribavirin[J].Viral Hepatitis, 2009, 16(8):578-585.

[7] 白金锡, 白贞子, 郑艳.36例慢性丙型肝炎抗病毒副作用及对策[J].中国实验诊断学, 2013, 17(2):346-347.

[8] Ganser A, Carlo-Stella C, Greher J, et al.Effect of recombinant interferons alpha and gamma on human bone marrow-derived megakaryocytic progenitor cells[J].Blood, 1987, 70(4):1173-1179.

[9] Liu YL, Du XF, Chen XY, et al.Bone marrow suppression or active proliferation? An analysis of neutropenia after pegylated interferon treatment of patients with chronic hepatitis C[J].Scand J Infect Dis, 2013, 45(12):939-943.

[10] Wada M, Marusawa H, Yamada R, et al.Association of genetic polymorphisms with interferon-induced haematologic adverse effects in chronic hepatitis C patients[J].J Viral Hepatitis, 2009, 16(6):388-396.

[11] Khakoo S, Glue P, Grellier L, et al.Ribavirin and interferon alfa2b in chronic hepatitisC;assessment of possible pharmacokinetic and pharmacodynamic interactions[J].J Pharmacol, 1998, 46(6):563-570.

[12] Hadziyannis SJ, Sette Jr H, Morgan TR, et al.PEGASYS International Study Group:Peginterferon-alpha2a and ribavirin combination therapy in chronic hepatitis C:a randomized study of treatment duration and ribavirin dose[J].Ann Intern Med, 2004, 140(5):346-355.

[13] Manns MP, McHutchison JG, Gordon SC, et al.Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C:a randomised trial[J].Lancet, 2001, 358(9286):958-965.

[14] D'Avolio A, De Nicolò A, Cusato J, et al.Association of ITPA polymorphisms rs6051702/rs1127354 instead of rs7270101/rs1127354 as predictor of ribavirin-associated anemia in chronic hepatitis C treated patients[J].Antiviral Res, 2013, 100(1):114-119.

[15] D'Avolio A, Ciancio A, Siccardi M, et al.Inosine triphosphatase polymorphisms and ribavirin pharmacokinetics as determinants of ribavirin-associate anemia in patients receiving standard anti-HCV treatment[J].Ther Drug Moni, 2012, 34(2):165-170.

[16] Rotman Y, Katz L, Cohen M, et al.Low weight predicts neutropenia and peginterferon alfa-2a dose reductions during treatment for chronic hepatitis C[J].J Viral Hepatitis, 2009, 16(5):340-345.

[17] Roomer R, Hansen BE, Janssen HLA, et al.Risk factors for infection during treatment with peginterferon alfa and ribavirin for chronic hepatitis C[J].Hepatology, 2010, 52(4):1225-1231.

[18] Roomer R, Hansen BE, Janssen HLA, et al.Thrombocytopenia and the risk of bleeding during treatment with peginterferon alfa and ribavirin for chronic hepatitis C[J].J Hepatol, 2010, 53(3):455-459.

[19] Lashin AH, Shaheen YA, Metwally MA, et al.Incidence and predictors of hematological side effects in chronic HCV Egyptian patients treated with pegylated interferon and ribavirin[J].Indian J Gastroenterol, 2013, 32(5):316-323.

[20] Scherzer TM, Stättermayer AF, Stauber R, et al.Effect of gender and ITPA polymorphisms on ribavirin-induced anemia in chronic hepatitis C patients[J].J Hepatol, 2013, 59(5):964-971.

Changes in number of peripheral blood cells in patients with chronic hepatitis C after treated with interferon alpha 2b combined with ribavirin and their clinical significances

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