Curbside Consultation of the Liver: 49 Clinical Questions

Mitchell L. Shiffman, MD

Question 5: When A Patient Receiving Peginterferon And Ribavirin Therapy Develops Anemia Should I Prescribe Epoetin Alfa Or Reduce The Dose Of The Ribavirin? (continued)

Mitchell L. Shiffman, MD

Anemia is a common adverse event when patients with chronic hepatitis C virus (HCV) receive peginterferon and ribavirin. A decline in the serum hemoglobin by 2 g or more occurs in approximately 75% of these patients and up to 20% have a decline in hemoglobin of more than 4 g.1 In large clinical trials the serum hemoglobin falls below 10 g/dL in approximately 20% of HCV patients during treatment; a decline in the hemoglobin to less than 8.5 g/dL occurs in about 5% of patients receiving peginterferon and ribavirin. Anemia significantly exacerbates the fatigue that many patients experience while…