Patient characteristics associated with peglyated interferon alfa‐2a induced neutropenia in chronic hepatitis C patients

Abstract

Neutropenia is a haematologic disorder commonly reported in patients with chronic hepatitis C virus (HCV) infection treated with pegylated interferon alfa-2a (PEG-IFN α-2a). The objective of the present project is to identify patient characteristics associated with neutropenia in hepatitis C patients. Demographic, clinical, and genetic data from 715 patients with chronic HCV infection treated with PEG-IFN α-2a and ribavirin. The outcome variable was the development of grade 3 or 4 neutropenia, defined as the decrease in neutrophil counts below 1 10 /L anytime during study. Predictors of neutropenia were identified using a 2-stage approach. First, univariate analysis was performed to identify possible predictors of neutropenia. T test was used for continuous variables and Fisher's exact test was used for categorical variables. Second, multiple logistic regression with stepwise addition was then performed using predictors identified in the univariate analysis step to produce final model containing independent predictors at P < .05. Logistic regression identified female gender, absolute neutrophils counts, and cholesterol level as the main predictors of neutropenia. Female gender increases the odds of experiencing neutropenia by 86% compared to male gender. A 1 unit (mmol/L) increase in cholesterol level decreases the odds of developing neutropenia by 13%. A 55% reduction in the likelihood of developing neutropenia for a 1 unit (10 /L) increase in the absolute neutrophils counts. Patients with high risk of developing neutropenia can be identified. Identification of this cohort allows early intervention to prevent neutropenia. Possible intervention is to administer drugs that raise neutrophil count such as filgrastim before neutropenia occurs.

A Biotechnological Approach for the Production of Pharmaceutically Active Human Interferon-α from Raphanus sativus L. Plants

“…IFN has been utilized in the treatment of hepatocellular carcinoma (HCC), albeit with some mixed results [ 33 , 52 , 53 , 54 ]. The current antitumor assay results, on the other hand, demonstrate that recombinant IFN-α2a generated in transgenic radish plants is capable of stopping cell growth and inducing cell apoptosis.…”

Development of highly stable and de-immunized versions of recombinant alpha interferon: Promising candidates for the treatment of chronic and emerging viral diseases

“…In particular, high rates of hematological adverse events such as anemia, leukopenia, neutropenia, and thrombocytopenia have been extensively reported in chronic Hepatitis C patients after IFN administration [ 68 ]. In fact, therapeutic doses of interferon may decrease neutrophil count by 30%–50%, while causing a dramatic increase in risk of bacterial infections and sepsis [ 69 ]. In this context, GMOP-IFN de-immunized variants developed in this study lack antiproliferative properties while preserving antiviral activity, representing interesting therapeutic alternatives for chronic Hepatitis C treatment.…”