Cirrhosis but not neutropenia is associated with the development of infection in patients with chronic hepatitis C undergoing treatment with pegylated interferon-alpha and ribavirin
Summary Peginterferon‐alpha (PegIFNa) frequently causes neutropenia, mainly due to bone marrow suppression. The aim of this study was to explore factors that are associated with infections during antiviral treatment. We analysed data from 275 chronic hepatitis C (CHC) patients with compensated liver...
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| Veröffentlicht in: | Journal of viral hepatitis 2014-09, Vol.21 (9), p.624-632 |
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| creator | Striki, A. Manolakopoulos, S. Deutsch, M. Mela, M. Kalafateli, M. Schini, M. Anagnostou, O. Triantos, C. Andreadis, I. Ketikoglou, I. Papatheodoridis, G. Pectasides, D. |
| description | Summary
Peginterferon‐alpha (PegIFNa) frequently causes neutropenia, mainly due to bone marrow suppression. The aim of this study was to explore factors that are associated with infections during antiviral treatment. We analysed data from 275 chronic hepatitis C (CHC) patients with compensated liver disease who underwent 318 courses of PegIFNa and ribavirin. Neutropenia was defined as neutrophils |
| doi_str_mv | 10.1111/jvh.12197 |
| format | Article |
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Peginterferon‐alpha (PegIFNa) frequently causes neutropenia, mainly due to bone marrow suppression. The aim of this study was to explore factors that are associated with infections during antiviral treatment. We analysed data from 275 chronic hepatitis C (CHC) patients with compensated liver disease who underwent 318 courses of PegIFNa and ribavirin. Neutropenia was defined as neutrophils <1000 cells/μL. Mean leucocytes count significantly decreased from baseline to treatment nadir (7081 ± 2182 vs 3293 ± 1331 cells/μL, P < 0.001), while neutropenia was observed in 32% during treatment. Thirty‐one infections were observed. The incidence rate for infection was assessed at 1.46 infections per 100 person‐months of therapy. The hazard rate for infection did not correlate with the neutrophils' nadir or the decrease in white blood cells. In multivariate Cox's regression analysis, cirrhosis was the only factor that was significantly associated with the occurrence of infection. Our data show that the development of bacterial infections during treatment with PegIFNa and ribavirin in patients with compensated CHC is not associated with reduction or the nadir of white cells or neutrophil counts. Baseline cirrhosis is the only factor related with infection during treatment. The common practice of dose adjustment or discontinuation of interferon should be revised; careful assessment of liver damage before therapy and close monitoring during therapy are essential in all patients receiving interferon‐based regimes, to minimize the detrimental consequences of infections.</description><identifier>ISSN: 1352-0504</identifier><identifier>EISSN: 1365-2893</identifier><identifier>DOI: 10.1111/jvh.12197</identifier><identifier>PMID: 24224747</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Antiviral Agents - adverse effects ; Antiviral Agents - therapeutic use ; Bacterial Infections - epidemiology ; chronic hepatitis C ; cirrhosis ; Female ; Hepatitis C virus ; Hepatitis C, Chronic - complications ; Hepatitis C, Chronic - drug therapy ; Humans ; infection's hazard ; Interferon-alpha - adverse effects ; Interferon-alpha - therapeutic use ; leucopenia ; Liver Cirrhosis - complications ; Male ; Middle Aged ; neutropenia ; Neutropenia - chemically induced ; Neutropenia - complications ; pegylated interferon-a ; Retrospective Studies ; Ribavirin - adverse effects ; Ribavirin - therapeutic use ; Young Adult</subject><ispartof>Journal of viral hepatitis, 2014-09, Vol.21 (9), p.624-632</ispartof><rights>2013 John Wiley & Sons Ltd</rights><rights>2013 John Wiley & Sons Ltd.</rights><rights>Copyright © 2014 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4577-58ca5f954457691a21ee0d743edb86646ac0b10c2d2bcb37311ca9a7741784513</citedby><cites>FETCH-LOGICAL-c4577-58ca5f954457691a21ee0d743edb86646ac0b10c2d2bcb37311ca9a7741784513</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjvh.12197$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjvh.12197$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24224747$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Striki, A.</creatorcontrib><creatorcontrib>Manolakopoulos, S.</creatorcontrib><creatorcontrib>Deutsch, M.</creatorcontrib><creatorcontrib>Mela, M.</creatorcontrib><creatorcontrib>Kalafateli, M.</creatorcontrib><creatorcontrib>Schini, M.</creatorcontrib><creatorcontrib>Anagnostou, O.</creatorcontrib><creatorcontrib>Triantos, C.</creatorcontrib><creatorcontrib>Andreadis, I.</creatorcontrib><creatorcontrib>Ketikoglou, I.</creatorcontrib><creatorcontrib>Papatheodoridis, G.</creatorcontrib><creatorcontrib>Pectasides, D.</creatorcontrib><title>Cirrhosis but not neutropenia is associated with the development of infection in patients with chronic hepatitis C undergoing treatment with pegylated interferon-alpha and ribavirin</title><title>Journal of viral hepatitis</title><addtitle>J Viral Hepat</addtitle><description>Summary
Peginterferon‐alpha (PegIFNa) frequently causes neutropenia, mainly due to bone marrow suppression. The aim of this study was to explore factors that are associated with infections during antiviral treatment. We analysed data from 275 chronic hepatitis C (CHC) patients with compensated liver disease who underwent 318 courses of PegIFNa and ribavirin. Neutropenia was defined as neutrophils <1000 cells/μL. Mean leucocytes count significantly decreased from baseline to treatment nadir (7081 ± 2182 vs 3293 ± 1331 cells/μL, P < 0.001), while neutropenia was observed in 32% during treatment. Thirty‐one infections were observed. The incidence rate for infection was assessed at 1.46 infections per 100 person‐months of therapy. The hazard rate for infection did not correlate with the neutrophils' nadir or the decrease in white blood cells. In multivariate Cox's regression analysis, cirrhosis was the only factor that was significantly associated with the occurrence of infection. Our data show that the development of bacterial infections during treatment with PegIFNa and ribavirin in patients with compensated CHC is not associated with reduction or the nadir of white cells or neutrophil counts. Baseline cirrhosis is the only factor related with infection during treatment. The common practice of dose adjustment or discontinuation of interferon should be revised; careful assessment of liver damage before therapy and close monitoring during therapy are essential in all patients receiving interferon‐based regimes, to minimize the detrimental consequences of infections.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Antiviral Agents - adverse effects</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Bacterial Infections - epidemiology</subject><subject>chronic hepatitis C</subject><subject>cirrhosis</subject><subject>Female</subject><subject>Hepatitis C virus</subject><subject>Hepatitis C, Chronic - complications</subject><subject>Hepatitis C, Chronic - drug therapy</subject><subject>Humans</subject><subject>infection's hazard</subject><subject>Interferon-alpha - adverse effects</subject><subject>Interferon-alpha - therapeutic use</subject><subject>leucopenia</subject><subject>Liver Cirrhosis - complications</subject><subject>Male</subject><subject>Middle Aged</subject><subject>neutropenia</subject><subject>Neutropenia - chemically induced</subject><subject>Neutropenia - complications</subject><subject>pegylated interferon-a</subject><subject>Retrospective Studies</subject><subject>Ribavirin - adverse effects</subject><subject>Ribavirin - therapeutic use</subject><subject>Young Adult</subject><issn>1352-0504</issn><issn>1365-2893</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU9vFCEYhydGY2v14BcwJF70MC0wMDBHs9rWplEP_rsRhnlnh3UWRmC27gfz-8nutj2YmEhCgDfP-xD4FcVzgk9JHmerzXBKKGnEg-KYVDUvqWyqh7s9pyXmmB0VT2JcYUwqysnj4ogySplg4rj4vbAhDD7aiNo5IefzhDkFP4GzGuWyjtEbqxN06MamAaUBUAcbGP20BpeQ75F1PZhkvcs7NOlkcz0eaDME76xBA-zqKfsWaHYdhKW3bolSAJ32mj09wXI77q-yLkHoITeXepwGjbTrULCt3thg3dPiUa_HCM9u15Piy_m7z4vL8vrjxfvFm-vSMC5EyaXRvG84y6e6IZoSANwJVkHXyrpmtTa4JdjQjramrURFiNGNFoIRIRkn1Unx6uCdgv85Q0xqbaOBcdQO_BwV4XX-U8nJ_6CcYCIlqzP68i905efg8kN2FMZUkkZm6vWBMsHHGKBXU7BrHbaKYLWLXeXY1T72zL64Nc7tGrp78i7nDJwdgBs7wvbfJnX19fJOWR46bEzw675Dhx-qFpXg6tuHC3V-9f0TfiuzpfoDscTI8w</recordid><startdate>201409</startdate><enddate>201409</enddate><creator>Striki, A.</creator><creator>Manolakopoulos, S.</creator><creator>Deutsch, M.</creator><creator>Mela, M.</creator><creator>Kalafateli, M.</creator><creator>Schini, M.</creator><creator>Anagnostou, O.</creator><creator>Triantos, C.</creator><creator>Andreadis, I.</creator><creator>Ketikoglou, I.</creator><creator>Papatheodoridis, G.</creator><creator>Pectasides, D.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201409</creationdate><title>Cirrhosis but not neutropenia is associated with the development of infection in patients with chronic hepatitis C undergoing treatment with pegylated interferon-alpha and ribavirin</title><author>Striki, A. ; Manolakopoulos, S. ; Deutsch, M. ; Mela, M. ; Kalafateli, M. ; Schini, M. ; Anagnostou, O. ; Triantos, C. ; Andreadis, I. ; Ketikoglou, I. ; Papatheodoridis, G. ; Pectasides, D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4577-58ca5f954457691a21ee0d743edb86646ac0b10c2d2bcb37311ca9a7741784513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Antiviral Agents - adverse effects</topic><topic>Antiviral Agents - therapeutic use</topic><topic>Bacterial Infections - epidemiology</topic><topic>chronic hepatitis C</topic><topic>cirrhosis</topic><topic>Female</topic><topic>Hepatitis C virus</topic><topic>Hepatitis C, Chronic - complications</topic><topic>Hepatitis C, Chronic - drug therapy</topic><topic>Humans</topic><topic>infection's hazard</topic><topic>Interferon-alpha - adverse effects</topic><topic>Interferon-alpha - therapeutic use</topic><topic>leucopenia</topic><topic>Liver Cirrhosis - complications</topic><topic>Male</topic><topic>Middle Aged</topic><topic>neutropenia</topic><topic>Neutropenia - chemically induced</topic><topic>Neutropenia - complications</topic><topic>pegylated interferon-a</topic><topic>Retrospective Studies</topic><topic>Ribavirin - adverse effects</topic><topic>Ribavirin - therapeutic use</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Striki, A.</creatorcontrib><creatorcontrib>Manolakopoulos, S.</creatorcontrib><creatorcontrib>Deutsch, M.</creatorcontrib><creatorcontrib>Mela, M.</creatorcontrib><creatorcontrib>Kalafateli, M.</creatorcontrib><creatorcontrib>Schini, M.</creatorcontrib><creatorcontrib>Anagnostou, O.</creatorcontrib><creatorcontrib>Triantos, C.</creatorcontrib><creatorcontrib>Andreadis, I.</creatorcontrib><creatorcontrib>Ketikoglou, I.</creatorcontrib><creatorcontrib>Papatheodoridis, G.</creatorcontrib><creatorcontrib>Pectasides, D.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of viral hepatitis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Striki, A.</au><au>Manolakopoulos, S.</au><au>Deutsch, M.</au><au>Mela, M.</au><au>Kalafateli, M.</au><au>Schini, M.</au><au>Anagnostou, O.</au><au>Triantos, C.</au><au>Andreadis, I.</au><au>Ketikoglou, I.</au><au>Papatheodoridis, G.</au><au>Pectasides, D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cirrhosis but not neutropenia is associated with the development of infection in patients with chronic hepatitis C undergoing treatment with pegylated interferon-alpha and ribavirin</atitle><jtitle>Journal of viral hepatitis</jtitle><addtitle>J Viral Hepat</addtitle><date>2014-09</date><risdate>2014</risdate><volume>21</volume><issue>9</issue><spage>624</spage><epage>632</epage><pages>624-632</pages><issn>1352-0504</issn><eissn>1365-2893</eissn><abstract>Summary
Peginterferon‐alpha (PegIFNa) frequently causes neutropenia, mainly due to bone marrow suppression. The aim of this study was to explore factors that are associated with infections during antiviral treatment. We analysed data from 275 chronic hepatitis C (CHC) patients with compensated liver disease who underwent 318 courses of PegIFNa and ribavirin. Neutropenia was defined as neutrophils <1000 cells/μL. Mean leucocytes count significantly decreased from baseline to treatment nadir (7081 ± 2182 vs 3293 ± 1331 cells/μL, P < 0.001), while neutropenia was observed in 32% during treatment. Thirty‐one infections were observed. The incidence rate for infection was assessed at 1.46 infections per 100 person‐months of therapy. The hazard rate for infection did not correlate with the neutrophils' nadir or the decrease in white blood cells. In multivariate Cox's regression analysis, cirrhosis was the only factor that was significantly associated with the occurrence of infection. Our data show that the development of bacterial infections during treatment with PegIFNa and ribavirin in patients with compensated CHC is not associated with reduction or the nadir of white cells or neutrophil counts. Baseline cirrhosis is the only factor related with infection during treatment. The common practice of dose adjustment or discontinuation of interferon should be revised; careful assessment of liver damage before therapy and close monitoring during therapy are essential in all patients receiving interferon‐based regimes, to minimize the detrimental consequences of infections.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>24224747</pmid><doi>10.1111/jvh.12197</doi><tpages>9</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Antiviral Agents - adverse effects Antiviral Agents - therapeutic use Bacterial Infections - epidemiology chronic hepatitis C cirrhosis Female Hepatitis C virus Hepatitis C, Chronic - complications Hepatitis C, Chronic - drug therapy Humans infection's hazard Interferon-alpha - adverse effects Interferon-alpha - therapeutic use leucopenia Liver Cirrhosis - complications Male Middle Aged neutropenia Neutropenia - chemically induced Neutropenia - complications pegylated interferon-a Retrospective Studies Ribavirin - adverse effects Ribavirin - therapeutic use Young Adult |
| title | Cirrhosis but not neutropenia is associated with the development of infection in patients with chronic hepatitis C undergoing treatment with pegylated interferon-alpha and ribavirin |
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