The study of relationship between neutropenia and infection during treatment with peginterferon α and ribavirin for chronic hepatitis C.

ABSTRACT

OBJECTIVE: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.