Sunday, October 17, 2010

Risk factors for infection during treatment for chronic Hep C

Neutropenia during treatment with peginterferon alfa and ribavirin for chronic hepatitis C virus infection is a common cause of dose reductions of peginterferon alfa.

These reductions are performed to prevent bacterial and fungal infections, which are common during hepatitis C virus treatment, and can be attributed to neutropenia.

Dr Robert de Knegt and colleagues from the Netherlands investigated the occurrence of infections and their relation to neutropenia, and identified potential risk factors for infections during hepatitis C virus treatment.

In this single-center cohort study, 2,876 visits of 321 patients treated with peginterferon alfa and ribavirin were evaluated for neutropenia, infections, dose reductions, and potential risk factors for infection during hepatitis C treatment.

The baseline mean absolute neutrophil count (ANC) was 3420 cells/μL, and 16 patients had a baseline ANC of less than 1500 cells/μL.

14% of infections were defined as severe
Hepatology
The research team observed neutropenia, defined as ANC less than 750 cells/μL, in 30% of patients, and ANC less than 375/μL in 5% of patients.

The research team found that 22% had infections.

The team noted that 14% of infections were defined as severe.

Infections were not correlated with neutropenia during treatment.

The team observed that dose reductions did not lead to a decrease in infection rate.

Multivariate logistic regression analysis revealed that age over 55 years, and baseline hyperglycemia were associated with an increased risk of infection during hepatitis C virus treatment.

Cirrhosis and chronic obstructive pulmonary disease were not risk factors for infection.

Dr de Knegt's team concluded, "Bacterial infections during treatment with peginterferon alfa and ribavirin are not associated with neutropenia."

"Older patients and patients with poorly controlled diabetes mellitus have a greater risk of developing infections during hepatitis C virus treatment."

No comments:

Post a Comment