Baseline factors associated with haematological toxicity that leads to a dosage reduction of pegylated interferon-α2a and ribavirin in HIV- and HCV-coinfected patients on HCV antiviral therapy

Daniel Fuster, Jaime A. Huertas, Guadalupe Gómez, Ricard Solà, Juan González García, Josep Vilaró, Enric Pedrol, Lluís Force, Jordi Tor, Guillem Sirera, Sebastiá Videla, Ramon Planas, Bonaventura Clotet, Cristina Tural

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19 Citations (Scopus)

Abstract

Objective: To assess the baseline factors associated with haematological toxicity that lead to ribavirin or pegylated interferon (peginterferon) dosage reductions in hepatitis C and human immunodeficiency virus (HCV/HIV)-coinfected patients. Design: Multicentre, prospective, observational study. Setting: Eleven hospitals in Spain during the period 2002-2003. Subjects and methods: One-hundred and forty-two HIV/HCV-coinfected patients received peginterferon-α2a plus ribavirin. Baseline characteristics and haematological parameters were recorded at baseline, week 4, 8, 12, 24 and 48. Cox's regression model was used to study the factors associated with the appearance of a haemoglobin level below 10g/dl (haemoglobin-endpoint), a neutrophil count below 750/mm3 (neutrophil-endpoint) and a platelet count below 50,000/mm3 (platelet-endpoint). Results: Nineteen patients (13.4%) reached the haemoglobin-endpoint, 22.5% the neutrophil-endpoint and 7% the platelet-endpoint. Mean time of follow-up was 8 months (±3.5). A baseline haemoglobin level below 14g/dl [hazard ratio (HR): 3.65; 95% confidence interval (CI): 1.46-9.06] and treatment with zidovudine (HR: 3.25; 95% CI: 1.31-8.11) were the independent factors associated with the appearance of the haemoglobin-endpoint. A baseline neutrophil below 2050/mm 3 (HR: 3.59; 95% CI: 1.77-7.28) and baseline weight <60 kg (HR: 2.21; 95% CI: 1.04-4.56) were independently associated with the appearance of the neutrophil-endpoint. Baseline platelet count (x1000/mm3 decrease) (HR: 1.074; 95% CI: 1.04-1.11) was independently associated with the appearance of the platelet-endpoint. Conclusions: Baseline factors allow the identification of a subset of HIV/HCV-coinfected patients who are prone to experience haematological toxicity during HCV antiviral therapy. © 2005 International Medical Press.
Original languageEnglish
Pages (from-to)841-847
JournalAntiviral Therapy
Volume10
Issue number7
Publication statusPublished - 28 Nov 2005

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