Hemoglobin concentration decline and its relationship with responses to therapy in patients with chronic hepatitis C

GUO Feng-xia; LI Jian-ping; CHEN Bin-bin; ZHANG Xia-yi; GUAN Yu-juan

doi:10.3969/j.issn.1001-9448.2017.05.009

Abstract：Objective To investigate the variety of hemoglobin concentration (Hb) and the decline of Hb on the responses to therapy in patients with chronic hepatitis C (CHC).Methods A total of 214 patients with CHC were prospectively treated with pegylated interferon α (PEG-IFN α) in combination with ribavirin (RBV) for 48 weeks.After finishing the therapy,the patients were followed up for 24 weeks and the therapeutic effect was evaluated with sustained virological response (SVR).Hb was tested at baseline,during the treatment and after the therapy.The factors affecting the Hb decline and the effect of Hb decline on responses to therapy were assessed.Results Hb decline (decline ≥ 30 g/L) was observed in 156 (72.9％) patients,anemia (Hb≤100 g/L) occurred in 86 (40.2％) patients,and Hb≤80 g/L occurred in 26 (12.2％) patients.Sex (P =0.000),age (P =0.000),weight (P =0.00),baseline creatinine clearance (P =0.000),baseline leukocyte count (P =0.000),baseline neutrophil count (P =0.019),baseline Hb (P =0.000) and baseline platelet count (P =0.037) were significantly associated with anemia.Hb ≤ 120 g/L (P =0.000) or a rapid decline in Hb of ≥30 g/L at Week 2 (P =0.000)was also significantly associated with the decline of Hb after Week 2.Neither Hb ≤100 g/L (P =1.000) nor Hb decline ≥30 g/L (P =0.646) during treatment was associated with SVR.Conclusion Several baseline factors,including female,older age,lower weight,lower creatinine clearance,and lower blood cells count are predictive of developing anemia.Hb decline at Week 2 is an important predictor for the Hb decline after that.And we could not predict SVR by testing Hb during treatment.