Review article: Optimising SVR and the management of haematological side effects of peginterferon/ribavirin antiviral therapy for HCV: The role of Epoetin,G-CSF and novel agents

Ross Mac Nicholas (1) , Suzanne Norris (2)

1 Department of Hepatology
2 Department of Hepatology

Background: Chronic hepatitis C is one of the leading causes for chronic liver disease globally. The past two decades have seen many advances in hepatitis C treatment. Despite these advances side effects of treatment are common. Haematological complications of treatment can result in treatment cessation and suboptimal results. Recent data has suggested a role for Epoetin/G-CSF in optimising SVR. Aim: To investigate the nature, frequency and management of haematological side effects in the treatment of chronic hepatitis C infection. Methods: The terms hepatitis C, HCV, treatment, side effects, Interferon, PegInterferon, Ribavirin, anaemia, haemoglobin, neutropaenia, thrombocytopaenia, haematological, growth factor, erythropoietin, granulocyte colony stimulating factor were searched on MEDLINE from 1991-2009. References from selected articles were also included. Results: Haematological side effects such as anaemia, neutropaenia and thrombocytopaenia are frequent in anti-HCV treatment.The off-label use of haematological growth factors is common and effective. Conclusions: Erythropoietic agents are effective in treating anaemia, preventing ribavirin dose reduction, improving patients' quality of life but the effect on SVR is not fully elucidated. G-CSF is effective in raising ANC, however neutropaenic HCV-infected patients on combination treatment may not experience increased bacterial infections. Eltrombopag a new oral thrombopoietin mimetic may allow combination treatment in patients with thrombocytopaenia..

Mots clés: Medicine

Ross Mac Nicholas, Suzanne Norris. Review article: Optimising SVR and the management of haematological side effects of peginterferon/ribavirin antiviral therapy for HCV: The role of Epoetin,G-CSF and novel agents. Alimentary Pharmacology and Therapeutics, 2010, ⟨10.1111/j.1365-2036.2010.04269.x⟩. ⟨hal-00552531⟩