HEPATITIS C

FREQUENCY OF THROMBOCYTOPENIA PATIENTS TREATED WITH INTERFERON

Abstract

Objectives: To determine the frequency of thrombocytopenia and its manifestations in patients with Chronic Hepatitis C Virus
infection treated with interferon and ribavirin. Data Source: In door and out door patients. Design of Study: Case series. Setting and Period
of Study: Department of Medicine PNS Shifa Hospital Karachi, from 1s t August 2006 to 1s t July 2007. Materials and Methods: A Proforma
was designed to enter the data of 100 patients fulfilling the inclusion criteria included in the study. Adult patients between the ages of 18 and
50 years of both gender were selected. Presence of anti HCV antibodies, elevated serum alanine transaminase, a positive polymerase chain
reaction for hepatitis C ribonucleic acid and compensated liver disease were prerequisites. All patients were treated with combination of
interferon and ribavirin. Blood counts, alanine transaminase and prothrombin time were done at baseline and at 2,4 & 8 weeks intervals after
starting interferon. A drop in platelets count below 100,000/cmm was taken as interferon induced thrombocytopenia. Results: In our study
thrombocytopenia occurred in 11 % patients. Grade 3 thrombocytopenia (platelet counts < 50,000) occurred in 01 patient out of hundred in which
there was severe gum bleeding and purpura so antiviral treatment was discontinued. Grade 2 thrombocytopenia (platelet counts between 50,000
- 75,000) was observed in 03% patients but there were no bleeding episodes, 50% reduction dose was done in these patients. Grade 1
thrombocytopenia (platelet counts between 75,000-100,000) was noticed in 07% patients but there were no bleeding manifestations and dose
reduction was not done. Conclusion: Combination therapy is well tolerated, however, it can cause life threatening complications like bleeding
episodes in a few patients. Bleeding complications and manifestations as a result of thrombocytopenia are uncommon.