[Incidence of haemolytic anaemia during combination therapy of chronic hepatitis C with interferon alpha-2b and ribavirin].

Objective: Analysis of incidence of haemolytic anaemia during INF-alpha + ribavirin (RBV) treatment of chronic hepatitis C (CHC).

Material And Methods: 95 patients (M=64, F=31, mean age: 42.5 +/- 11.9) with CHC. All patients received IFN-alpha 3 MU three times a week and 1000-1200 mg of RBV daily. Basic haematological and biochemical parameters were checked. HCV-RNA (Cobas Amplicor, Roche) was checked before and after 6 months of therapy.

Results: After the first month of treatment a reduction of haemoglobin level occurred at 30% patients (not always characteristic for anaemia), an increase of the total bilirubin was observed in 16.8%, ferrum in 15.8%, while that of lactate dehydrogenase only in 22.1%. 37% of the patients required a reduction of ribavirin doses. No patient had treatment stopped because of side effects.

Conclusions: Lower HGB, RBC, WBC, HCT and PLT levels and raised total and unconjugated bilirubin levels were the most frequent changes observed during the combined antiviral treatment. Improvement of haematological and biochemical parameters most often occurs spontaneously or after RBV dose reduction. Presence of haemolytic anaemia does not require stopping of RBV treatment, but only RBV dose reduction. At about 2/3 of patients who start therapy with interferon and RBV treatment has to be continued up to 48 weeks.