Saudi Journal of Gastroenterology
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Year : 2008  |  Volume : 14  |  Issue : 3  |  Page : 151-157

Role of hematopoietic growth factors as adjuncts in the treatment of chronic hepatitis C patients


1 Human Genetics Division, MP 808, Southampton General Hospital, Southampton, United Kingdom
2 Department of Medicine (Unit-I), Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan
3 Department of Pediatrics, Holy Family Hospital, Rawalpindi, Pakistan
4 Foundation University Medical College (FUMC), Rawalpindi, Pakistan
5 Department of Surgery (Unit-II), Rawalpindi General Hospital, Rawalpindi, Pakistan

Correspondence Address:
Saeeda Yasmin
1156 57, Lyton Street, Adam-Jee Road, Rawalpindi
Pakistan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-3767.41739

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Drug-induced hematotoxicity is the most common reason for reducing the dose or withdrawing ribavirin (RBV) and interferon (IFN) therapy in chronic hepatitis C, which leads to the elimination of a possible cure for the patient. Traditionally, severe anemia and neutropenia have been considered as absolute contraindications to start antiviral therapy. This has not however, been the case since the advent of adjunct therapy with hematopoietic growth factors (erythropoietin (EPO) and granulocyte-colony stimulating factor (G-CSF)). Some recent landmark studies have used this adjunct therapy to help avoid antiviral dose reductions. Although the addition of this adjunct therapy has been shown to significantly increase the overall cost of the treatment, this extra cost is worth bearing if the infection is cured at the end of the day. Although more studies are needed to refine the true indications of this adjunct therapy, determine the best dose regimen, quantify the average extra cost and determine whether or not the addition of this therapy increases the sustained virological response rates achieved, the initial reports are encouraging. Therefore, although not recommended on a routine basis, some selected patients may be given the benefits of these factors. This article reviews the current literature on this subject and makes a few recommendations to help develop local guidelines.


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