Factors inftuencing ribavirin-induced hemolysis

BackgroundlAims: One of the major side eft'ects of the combination therapy for chronic hepatitis C is ribavirininduced hemolytic anemia. Little is known about variables inftuencing tbis anemia. Our study tried to search for these variables in a large group of patients with hepatitis C treated with the combination therapy. Methods: Two hundred and forty-four patients chronically infected with the hepatitis C virus were treated either with induction treatment (daily dose ofinterferon) or with a standard treatment (interferon thrice weekly). Both groups received 1000-1200 mg of ribavirin from week 4 until the end of the treatment. The drop in hemoglobin level was defined as the dift'erence between the pretreatment hemoglobin level and the hemoglobin level at week 8. Seventeen variables which could possibly influencê'this drop in hemoglobin level were examined.
Results: After multivariate analysis, the drop in hemoglobin level was only significant influenced by pretreatment platelet level, treatment and haptoglobin phenotype. The ribavirin dose did not influence the drop in hemoglobin level or the early virological response. Conclusions: Ribavirin-induced hemolysis is inftuenced by the pretreatment platelet level, the administered amount
of a-interferon and the haptoglobin phenotype. A careful search for the minimal dose of ribavirin needed in combination treatment is necessary.