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Hepatitis C is a major public health problem globally. It is one of the commonest cause of
chronic liver disease in Pakistan. The prevalent genotype is “3” in our country. The standard of
care treatment is combination of interferon and ribavirin. This combination has important adverse effects especially hemolytic anemia.
AIMS & OBJECTIVES: This study has been conducted to determine the frequency of anemia (<
10gm/dl) at 4, 12 and 24 weeks of interferon and ribavirin treatment CAH-C Genotype-3patients
along with assessment of associated risk factors.
PLACE AND DURATION: This study was conducted in department of Gastroenterology & Hepatology, Isra University Hospital, Hyderabad, Sindh from April 2009 to October 2010.
STUDY DESIGN: Prospective & case series study
MATERIALS AND METHODS: All patients who fulfilled the inclusion and exclusion criteria were
enrolled. The proforma was filled after patients verbal consent, by asking questions .Their BMI
was recorded and other demographic characteristics were also noted .Patients were followed
at 4,8,12,16,20 and 24 week. Their Blood CP was checked and if Hb fall within the range of 10.1
- 11.9 mg/dL then the dose of ribavirin was reduced (200 mg/day reduction) and if Hb was <8.5 g/
dL then both drugs were stopped altogether.
RESULTS: A total of 140 patients were remained for final analysis. Male were 73(52%, n = 140).
Only 18(13%, n = 140) patients developed anemia at week 4 of treatment. Compared to baseline
mean Hb% SD 13.31+1.18 (12 to 17 gm/dl), week 4 post treatment mean Hb +SD (Range) was
11.2 + 1.15(gm/dl. Almost 76.4% (107) of patients dropped hemoglobin more than two grams at
week 4 from baseline. The mean Hb% level at week 12 of treatment was 11.2 gm/dl. There were
31 (22%) patients developed anemia Hb<10.0 gm/dL .It was significantly seen in females. One
hundred and seven (76.4%) patients dropped Hb more than 2 gm at week 12.
Total of 30 (18%) patients developed anemia (Hb<10.0 gm/dL) at week 24. Mean hemoglobin
level at week 24 was 11.1 gm/dl. Anemia at week 4 & 12 were the two strong predicators of anemia at week 24. Other significant factors associated with anemia at week 24, were female sex
and body weight less than 60kg at baseline.
CONCLUSION: Anemia is a frequent complication of Anti HCV therapy.
Aftab Ahmed Sheikh, Mona Humaira, Madiha Zaki , Mohammad Adnan Bawani, Sadik Memon. (2013) Severity of Anemia during Interferon and Ribavirin Therapy in Patients with Chronic Active Hepatitis C Genotype-3 and its Association with Risk Factors , Journal of Liaquat University of Medical and Health Sciences, Volume-12, Issue-3.
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