Factors influencing ribavirin-induced hemolysis

Background/Aims: One of the major side effects of the combination therapy f or chronic hepatitis C is ribavirin-induced hemolytic anemia. Little is kno wn about variables influencing this anemia. Our study tried to search for t hese variables in a large group of patients with hepatitis C treated with t he combination therapy. Methods: Two hundred and forty-four patients chronically infected with the hepatitis C virus were treated either with induction treatment (daily dose of interferon) or with a standard treatment (interferon thrice weekly), Bot h groups received 1000-1200 mg of ribavirin from week 4 until the end of th e treatment. The drop in hemoglobin level was defined as the difference bet ween the pretreatment hemoglobin level and the hemoglobin level at week 8, Seventeen variables which could possibly influence this drop in hemoglobin level were examined. Results: After multivariate analysis, the drop in hemoglobin level was only significant influenced by pretreatment platelet level, treatment and hapto globin phenotype, The ribavirin dose did not influence the drop in hemoglob in level or the early virological response. Conclusions: Ribavirin-induced hemolysis is influenced by the pretreatment platelet level, the administered amount of alpha -interferon and the haptog lobin phenotype. A careful search for the minimal dose of ribavirin needed in combination treatment is necessary, (C) 2001 European Association for th e Study of the Liver. Published by Elsevier Science B,V, All rights reserve d.