الفهرس | Only 14 pages are availabe for public view |
Abstract he aim of our study is to evaluate the usefulness of leucopenia and neutropnia as predictors of sustained virological response to treatment of chronic hepatitis C with PEG-IFN and Ribavirin for 48 weeks. The study included 200 patients with chronic hepatitis C infection attending the interferon clinic of madinet nasr police hospital, Al-Agouza police hospital and Al-Qahira Al-Gadida hospital. All patients were subjected to: Careful history taking. Full clinical examination to detect manifestations of chronic liver disease, its complications or other associated diseases. Laboratory investigations: 1- Complete blood picture. 2- Liver function tests as serum AST, ALT, serum bilirubin, serum albumin, INR. 3- Renal function tests: serum creatinine and blood urea. 4- Fasting and post prandial blood glucose level. 5- Preparatory investigations before interferon therapy to exclude autoimmune causes of chronic liver T disease (ANA, ASMA and AMA) or thyroid disease (free T3, free T4 and TSH). 6- Abdominal ultrasound and liver biopsy to detect the stage of fibrosis. In the studied group: 1- We found no statistically difference between anemia, leucopenia, neutropenia and thrombocytopenia at weeks 12, 24 and 48 of treatment and cases age. 2- There is no statistically difference between male and female patients in regard to occurrence of hematological toxicity on weeks 12, 24 and 48 weeks of treatment. 3- It was found that there is no significant difference between cases with pretreatment HCV PCR ≥ 720000 IU/ml or <720000 IU/ml and occurrence of hematological toxicities on weeks 12, 24 and 48 of treatment. 4- It was found that occurrence of anemia on weeks 12, 24 and 48 weeks of treatment is significantly associated with SVR. 5- It was found that there is no statistical difference between patients with and without leucopenia at weeks 12, 24 and 48 of treatment and achieving SVR. 6- It was found that there is no statistical difference between patients with and without neutropenia at weeks 12, 24 and 48 of treatment and achieving SVR. 7- It was found that there is no statistical difference between patients with and without thrombocytopenia at weeks 12, 24 and 48of treatment and achieving SVR. 8- Independent factors that are significantly associated with higher SVR are: female sex (p=0.016), pretreatment HCV PCR <720000 IU/ml (p=0.001), occurrence of anemia, neutropenia, or thrombo-cytopenia at week 12 of treatment (p=0.0001, 0.036 and 0.038 respectively), occurrence of leucopenia at week 24 of treatment (p=0.003) and occurrence of anemia at week 48 of treatment (p=0.039). |