aTexas Children's Hematology Center, Baylor College of Medicine, Houston, Texas bDivision of Hematology-Oncology, Veterans Affairs Medical Center and University of Tennessee Health Science Center cDivision of Gastroenterology and Hepatology, Veterans Affairs Medical Center and University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Curr Opin Hematol. 2014 Jan;21(1):58-63. doi: 10.1097/MOH.0000000000000006.
This review describes the pathogenesis and therapeutic implications of neutropenia in patients with hepatitis C.
Mild-to-moderate neutropenia is increasingly recognized as the hepatitis C population has caused increased cirrhosis. Multiple mechanisms for the neutropenia have been postulated, with recent evidence pointing toward a combination of hypersplenism, autoimmunity, and direct viral infection of bone marrow cells. Advances in antiviral therapy are associated with worsened neutropenia and dose modification. Severe neutropenia is underreported and is generally not associated with increased rates of infection.
Although neutropenia is common in hepatitis C patients it generally has a benign course and may not prohibit antiviral therapy.
本文描述了丙型肝炎患者中性粒细胞减少症的发病机制和治疗意义。
随着丙型肝炎患者肝硬化的增加，越来越多的人认识到轻度至中度中性粒细胞减少症。已经提出了多种导致中性粒细胞减少症的机制，最近的证据指向脾功能亢进、自身免疫和骨髓细胞的直接病毒感染的组合。抗病毒治疗的进展与中性粒细胞减少症的恶化和剂量调整有关。严重的中性粒细胞减少症报告较少，一般与感染率的增加无关。
虽然丙型肝炎患者常出现中性粒细胞减少症，但一般病程良好，且可能不会妨碍抗病毒治疗。
