The Influence Of Interferon Alpha2b With Ribavirin Therapy On Peripheral Blood Cells In Patients With Chronic Hepatitis C

Objective: To explore the the dynamic changes and the factors influencing changes ofperipheral blood cells in patients with chronic hepatitis C receiving interferon alpha2b with ribavirin therapy,and to clarify the impact of peripheral blood cells changeson SVR rates.Methods:343CHC patients from Gengxin and Desheng Township of Fuyu Countyin Jilin Province were enrolled,they were discovered from a epidemiologicalinvestigations by Department of Hepatis-Biliary-Pancreatic in the First Hospital ofJilin University in2009~2010.All patients received IFN-a-2b (5,000,000U, everyother day,subcutaneous)combined with ribavirin (15mg/kg.d, oral)for48weeks.Theperipheral blood cells and serum HCV RNA level were assessed at12,24,36,48,60,72and96weeks.The patients who developed Neutropenia,Anemia andThrombocytopenia would be treated according to"2010Hepatitis C TreatmentGuidelines".Results:1.The prevalence of Neutropenia,Anemia and Thrombocytopenia were40.5%(139),48.4%（166) and39.9%（137) respectively. There were changes in peripheralblood cells of individual patients after treatment.The most of changes occured fromthe beginning to12weeks.2.There were significantly decreased in neutrophils, hemoglobin and plateletsin in2weeks, while a minimum value to12weeks, after that would have a slow rise.At theend of treatment (48weeks),although recovery is obvious, but not yet reachedpre-treatment levels.They would be recoved at60to72weeks.3.Baseline of ANC,PLT,AST, ALT and liver fibrosis associated with Neutropenia（p<0.05）.Gender and baseline of hemoglobin levels were related to Anemia（p<0.05）.Gender,baseline of ANC,PLT,AST, ALT, r-GT and liver fibrosisassociated with Thrombocytopenia（p<0.05）. 4.Hemoglobin drops more than1.9g/dl at2week or platelet counts drops more than5×109/L at4week means that the patient would have more opportunities to sufferfrom Anemia or Thrombocytopenia, respectively.5.Neutrophils decline in either a monitoring point had no predictive effect on SVR.Ifthe decline of hemoglobin at4week more than2.9g/dl,it would have a predictivesignificance for SVR,as well as the decline of PLT less than11.5×109/L in4weeks.Conclusinon：1.There is significantly decrease in peripheral blood cell in2weeks at the beginningof anti-virus therapy,and a minimum at12week.That remind clinicians shouldintervention and follow up timely to avoid serious adverse events.2.The occurrence and severity of reduction in peripheral blood cells coule be assessedaccording to the baseline gender, level of peripheral blood cells, liver function andliver fibrosis.3.Hemoglobin drops at2week or platelet counts drops at4week could may indicatethe opportunities to suffer from Anemia or Thrombocytopenia, respectively.4.The decline of hemoglobin at4week may have a predictive significance for SVR,aswell as the decline of PLT.