Department of Infectious Diseases, Second Affiliated Hospital, Harbin Medical University, Harbin, China.
Eur J Gastroenterol Hepatol. 2011 Nov;23(12):1192-9. doi: 10.1097/MEG.0b013e32834c5b32.
Neutropenia is frequent during treatment of chronic hepatitis C (CHC) with peginterferon and ribavirin. It remains unclear whether neutropenia is associated with infection in CHC. The aim was to study the relationship between neutropenia and infection during treatment with peginterferon and ribavirin for CHC.
A retrospective cohort on 399 patients treated with peginterferon α and ribavirin derived from our hospital database was conducted. The occurrence of infections and their relationship to neutropenia were investigated. Potential risk factors for infection were identified by multivariate analysis.
During treatment, neutropenia [absolute neutrophil counts (ANC) <1.5 × 10⁹/l] occurred in 251 patients, mild neutropenia [ANC (0.75-1.5) × 10⁹/l] occurred in 132 patients, moderate neutropenia [ANC (0.50-0.75) × 10⁹/l] occurred in 103 patients, and severe neutropenia (ANC<0.50 × 10⁹/l) occurred in 16 patients. Eighty infections (20.1%) occurred, 14 infections (17.5%) were defined as severe. There was no significant difference in infection rate between patients with and without moderate and severe neutropenia (21.0%, 25/119 vs. 19.6%, 55/280; χ²=0.097, P=0.755). There was no significant difference in infection rate between patients with and without peginterferon dose modifications (21.5%, 31/144 vs. 19.2%, 49/255; χ²=0.307, P=0.580). In multivariate logistic regression analysis, the independent factors associated with infection were age (P=0.021), diabetes (P=0.004), and cirrhosis (P=0.012).
Infections during treatment with peginterferon α and ribavirin for CHC are not associated with neutropenia. The independent factors associated with infection are age, diabetes, and cirrhosis.
聚乙二醇干扰素和利巴韦林治疗慢性丙型肝炎（CHC）期间常发生中性粒细胞减少症。目前尚不清楚中性粒细胞减少症是否与 CHC 感染有关。本研究旨在探讨聚乙二醇干扰素和利巴韦林治疗 CHC 期间中性粒细胞减少症与感染的关系。
对我院数据库中 399 例接受聚乙二醇干扰素α和利巴韦林治疗的患者进行回顾性队列研究。调查感染的发生情况及其与中性粒细胞减少症的关系。采用多因素分析确定感染的潜在危险因素。
治疗期间，251 例患者发生中性粒细胞减少症（绝对中性粒细胞计数（ANC）<1.5×109/L），132 例患者发生轻度中性粒细胞减少症（ANC（0.75-1.5）×109/L），103 例患者发生中度中性粒细胞减少症（ANC（0.50-0.75）×109/L），16 例患者发生重度中性粒细胞减少症（ANC<0.50×109/L）。发生 80 例感染（20.1%），14 例感染（17.5%）定义为重度感染。中重度中性粒细胞减少症患者感染率与无中性粒细胞减少症患者比较差异无统计学意义（21.0%，25/119 比 19.6%，55/280；χ2=0.097，P=0.755）。有或无聚乙二醇干扰素剂量调整的患者感染率比较差异亦无统计学意义（21.5%，31/144 比 19.2%，49/255；χ2=0.307，P=0.580）。多因素 logistic 回归分析显示，感染的独立相关因素为年龄（P=0.021）、糖尿病（P=0.004）和肝硬化（P=0.012）。
聚乙二醇干扰素α和利巴韦林治疗 CHC 期间的感染与中性粒细胞减少症无关。感染的独立相关因素为年龄、糖尿病和肝硬化。
