[977] NEUTROPENIA AS AN ADVERSE DRUG REACTION IN PATIENTS CO-INFECTED WITH HIV/HCV RECEIVING INTERFERON AND RIBAVIRIN THERAPY

2nd International AIDS Society Conference on HIV Pathogenesis and Treatment

Paris, France - July 13 - 16, 2003

[TITLE:] NEUTROPENIA AS AN ADVERSE DRUG REACTION IN PATIENTS CO-INFECTED WITH HIV/HCV RECEIVING INTERFERON AND RIBAVIRIN THERAPY

[AUTHOR(S):] J Slim, G John, S Smith and J Fallon
Saint Michael’s Medical Center, Newark, USA

IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd: Abstract No. 977
Antiviral Therapy 2003; 8(Suppl. 1):S460

[ABSTRACT:] Introduction: Treatment of HCV in HIV-infected patients is still in an experimental stage. Initial studies show a lower response rate and a higher incidence of adverse drug reaction (ADR). We thought to look at neutropenia as an ADR related to hepatitis C treatment in this population.

Method: Retrospective chart review of patients coinfected with HIV/HCV who were treated for hepatitis C with interferon (alpha 2a or 2b) and ribavirin. Data collected consisted of epidemiology, baseline CD4, HIV PCR, ANC and followed those values while on therapy and the use of GCSF for those patients who developed neutropenia (mild 750–1000, moderate 500–749, severe <500) and monitor bacterial infection rate.

Results: 50 patients undergoing treatment for hepatitis C were eligible for the study, 36 males, 14 females, average age 47 years, average length of treatment 20 weeks, baseline mean CD4 of 472, median HIV PCR <400, mean absolute neutrophil count (ANC) 2910. Risk factors for HCV were 41 patients IVDU, 6 patients sexual contact, 3 patients blood transfusions. 21 patients developed neutropenia (5 mild, 12, moderate, 4 severe) and the mean baseline ANC for patients developing neutropenia was 2880. The mean time to developing neutropenia was 11.6 weeks. 21 patients were treated with GCSF at a dose of 300 mcg TIW with a mean GCSF therapy of 16 weeks. Six patients developed eight bacterial infections, only three of them were neutropenic, with seven bacterial infections requiring hospitalization.

Conclusions: In this study patients co-infected with HIV/HCV had a higher incidence of neutropenia (42%) and required GCSF therapy as compared to patients with HCV mono-infection (15–20%). None of the patients died of bacterial sepsis, but the occurence of bacterial infection was high. More prospective studies focusing on neutropenia, bacterial infections, and prevention.

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