Anemia Drug Helpful in Patients with Hepatitis C
Reuters
Wed Dec 24, 3:07 PM ET
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NEW YORK (Reuters Health) - The red blood cell-boosting drug erythropoietin improves hemoglobin levels in patients with anemia caused by the drugs used to treat hepatitis C.

The hepatitis C virus can cause permanent liver damage, cancer, or even death. Early symptoms include fatigue, which can progress to the yellow staining of the skin called jaundice and swelling of the abdomen. People can get the virus through any exposure to infected blood, including intravenous drug use, body piercing, tattooing, unbandaged cuts or poorly sterilized medical equipment and blood transfusions.

Standard treatment for hepatitis C infection includes the immune system protein interferon alfa in combination with the antiviral agent ribavirin, both of which are associated with decreased hemoglobin levels, Dr. Douglas T. Dieterich and his associates note in The American Journal of Gastroenterology. When anemia results, ribavirin doses are usually reduced to levels that are likely to be less effective in controlling the hepatitis C virus.

Dieterich, from Mount Sinai School of Medicine, New York, and colleagues evaluated the efficacy of once-weekly doses of epoetin alfa in alleviating anemia and minimizing ribavirin dose reductions in 64 anemic, HCV-infected patients.

After 16 weeks, patients assigned to epoetin alfa treatment had higher mean hemoglobin levels than did patients assigned to standard care, the authors report.

Moreover, 83 percent of patients receiving epoetin alfa maintained daily ribavirin doses of 800 mg or more, compared with only 54 percent of patients receiving standard care.

Improvements in quality of life measures were greater in the epoetin alfa treatment group than in the standard care group, the investigators report, and epoetin alfa treatment was well tolerated.

"Based on the results of this study," the authors conclude, "epoetin alfa seems to be promising for the treatment of anemia in HCV-infected patients receiving ribavirin/interferon combination therapy. Further research is warranted to investigate the potential impact of epoetin alfa therapy on outcomes, including quality of life and sustained viral response."

SOURCE: American Journal of Gastroenterology, November 2003.