Ong Janus P, Younossi Zobair M
Center for Liver Diseases, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042, USA.
Cleve Clin J Med. 2004 May;71 Suppl 3:S17-21. doi: 10.3949/ccjm.71.suppl_3.s17.
Hematologic abnormalities such as anemia, neutropenia, and thrombocytopenia are common during combination therapy with pegylated (or standard) interferon and ribavirin for chronic hepatitis C. Ribavirin-induced hemolytic anemia is a common cause of dose reduction or discontinuation. Bone marrow suppression also contributes to the anemia and is the predominant mechanism for interferon-induced neutropenia and thrombocytopenia. Although dose reduction or discontinuation of combination therapy can reverse these abnormalities, they may reduce virologic response. Hematopoietic growth factors may provide a useful alternative for managing these hematologic side effects without reducing the optimal dose of the combination antiviral regimen. Treatment of anemia also may improve patients' health-related quality of life and their adherence to combination antiviral therapy. The impact of growth factors on sustained virologic response and their cost-effectiveness in patients with chronic hepatitis C need further assessment.
在聚乙二醇化（或标准）干扰素与利巴韦林联合治疗慢性丙型肝炎期间，贫血、中性粒细胞减少和血小板减少等血液学异常很常见。利巴韦林诱导的溶血性贫血是剂量减少或停药的常见原因。骨髓抑制也导致贫血，并且是干扰素诱导的中性粒细胞减少和血小板减少的主要机制。虽然减少联合治疗的剂量或停药可以逆转这些异常，但可能会降低病毒学应答。造血生长因子可能为管理这些血液学副作用提供一种有用的替代方法，而无需降低联合抗病毒方案的最佳剂量。贫血的治疗也可能改善患者与健康相关的生活质量及其对联合抗病毒治疗的依从性。生长因子对持续病毒学应答的影响及其在慢性丙型肝炎患者中的成本效益需要进一步评估。
