Abstract :
Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzymatic
disorder of red blood cells. It is uncertain whether ribavirin (RBV) is associated with more severe anemia in pa-
tients with this disorder. The aim of this study was to evaluate the severity of anemia in patients with GPD defi-
ciency treated at Siriraj hospital during pegylated interferon and ribavirin therapy for chronic hepatitis C (CHC).
Method: CHC patients treated with pegylated interferon/ribavirin and followed at Siriraj hospital were
enrolled. All patients were tested for G6PD level. Their medical records were reviewed, data including baseline
clinical characteristics, complete blood count (CBC) at week 0, 4, 8 12, 24, 48 and 12 after treatment. Index cases
with G6PD deficiency were matched 1:3 with normal G6PD controls with regard to age, sex, HCV genotype and
treatment with pegylated interferon alfa2a or 2b plus ribavirin.
Results: Of 186 CHC patients tested, there were 12 with G6PD deficiency (6 male and 6 female) and 36
controls. All baseline characteristic were similar in both groups except baseline Hb level in patients with G6PD
deficiency which was lower than in controls (13.3 ± 1.5 gm/dL vs 14.2 ± 1.2, p=0.046). Six patients with G6PD
deficiency (50%) and 16 patients without G6PD deficiency (44.4%) received erythropoietin during the course of
treatment. There was no difference in the average doses of ribavirin in patients with or without erythropoietin.
There was no difference in sustained virological response (SVR). We have observed that controls who did not
received erythropoietin had statistical significant declined in Hb level at week 8, 12, 24 after treatment when
compared with patients with G6PD deficiency.
Conclusion: CHC with G6PD deficiency can be treated successfully with pegylated interferon/ribavirin
without an increased risk of ribavirin-induced anemia. |
file/Thai-Journal-of-gastroenterology-vol-14-no-1-4570304.pdf