Management of anemia induced by triple therapy in patients with chronic hepatitis C: challenges, opportunities and recommendations.

摘要: The addition of protease inhibitors, boceprevir or telaprevir, to peginterferon+ribavirin (PegIFN/RBV) increases the frequency as well severity, and hence, clinical relevance anemia, which has now become one major complications associated with triple therapy. Most significant factors anemia in patients receiving therapy include older age, lower body mass index (BMI), advanced fibrosis, baseline hemoglobin. variability inosine triphosphate pyrophosphatase (ITPA) gene, encodes a protein that hydrolyses (ITP), been identified an essential genetic factor for both dual correct management is based on anticipation, characterization therapeutic management. Basically, can be characterized 3 types: ferropenic (mostly fertile women), thalassemic type hemolytic from chronic processes. Functional deficit iron should also excluded normal ferritin saturation transferrin. Ribavirin dose reduction epoetin, sequentially, are indicated anemia. Epoetin non-response caused by lack time, functional erythropoietin resistance. In transplantation setting, adding inhibitor PegIFN/RBV results increase incidence severity and, consequence, greater need transfusions, ribavirin reductions. Packed red cell transfusions utilized when hemoglobin decreases less than 7.5g/dl and/or there symptoms no response other measures.