Comparison of Blood Cell Changes between Interferon Alpha Monotherapy and Interferon Alpha Combination Therapy with Ribavirin in Patients with Chronic Hepatitis C

• Published in: Iryo Yakugaku (Japanese Journal of Pharmaceutical Health Care and Sciences) Vol. 31; no. 5; pp. 337 - 343
• Main Authors: Takahashi, Yasushi, Saitoh, Hiroshi, Gotoh, Yoshikazu, Hara, Kentarou, Iwai, Shinji, Kobayashi, Michiya, Kurosawa, Takao, Tadano, Kohji, Higuchi, Akifumi, Sawazaki, Rinako, Yamamoto, Asuka, Nagasaka, Atsushi
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Pharmaceutical Health Care and Sciences 10.05.2005
• Subjects: anemia; chronic hepatitis C; interferon α-2b; leukopenia; ribavirin; thrombocytopenia
• ISSN: 1346-342X; 1882-1499
• DOI: 10.5649/jjphcs.31.337

Combination therapy consisting of interferon (IFN) alpha 2b and ribavirin is effective for IFN-tolerant chronic hepatitis C. However, this therapy often causes anemia and other serious disorders of the red blood cells (RBC). On the other hand, IFN monotherapy causes leukopenia and thrombocytopenia. Up till now, little information has been available on the differences in adverse effects on blood cells between IFN monotherapy and IFN combination therapy with ribavirin. In this study, therefore, we investigated changes in RBC, white blood cells (WBC), platelets and hemoglobin levels in patients who underwent IFN monotherapy (n=6) and IFN combination therapy with ribavirin (n=22) in the Department of Gastroenterology of Sapporo City General Hospital. There were marked decreases in RBC and hemoglobin levels in the initial stage (1 to 4 weeks) of combination therapy and their levels did not recover in the remaining period of the therapy. In contrast, there was no appreciable change in these levels in the case of IFN monotherapy. WBC and platelets decreased in all patients in the initial stage for both therapies and there was no significant difference in their levels between monotherapy and combination therapy. One month after completing the two types of therapy, WBC and platelets had returned to their initial levels. On the other hand, it took 2 months for RBC and hemoglobin levels to recover. These data suggest that combination therapy with ribavirin specifically increases the incidence of anemia as compared with IFN monotherapy and that it is important to monitor RBC and hemoglobin levels after completion of IFN combination therapy with ribavirin.