Severe Neutropenia in Patients with Chronic Hepatitis C: A Benign ConditionSheehan V. · Weir A. · Waters B.
aHematology Center, Department of Pediatrics, Baylor College of Medicine, Houston, Tex., and bVeterans Affairs Medical Center and University of Tennessee Health Sciences Center, Memphis, Tenn., USA
Background/Aims: Patients with chronic hepatitis C virus (HCV) infection may develop neutropenia, which can delay or prevent treatment. Severe neutropenia, absolute neutrophil counts (ANC) ≤0.500 × 109/l, is a rare finding, with only two isolated reports published in the literature. The aim of this study was to evaluate the incidence and natural history of severe neutropenia in hepatitis C patients. Methods: The records of 685 patients with active HCV were reviewed to identify those with severe neutropenia. The laboratory parameters and clinical history data of patients with severe neutropenia were then compared to a cohort of patients with HCV patients who had the more common minor neutropenia (ANC = 1.000–1.500 109/l). Results: There was no significant difference in race, MELD (Model for End Stage Liver Disease) scores, portal hypertension, splenomegaly, viral load, viral type, or hemoglobin or platelet levels. Neither group suffered serious systemic infections. Conclusions: Severe neutropenia in HCV patients is underreported and not associated with serious HCV complications such as elevated MELD score or cirrhosis. Serious infection is rare and patients respond well to granulocyte colony-stimulating factor. Severely neutropenic patients with HCV appear to have a benign course and may be candidates for antiviral therapy.
Alva Weir, MD
Veterans Affairs Medical Center
1030 Jefferson Avenue
Memphis, TN 38104 (USA)
Received: June 13, 2012
Accepted after revision: August 23, 2012
Published online: November 21, 2012
Number of Print Pages : 5
Number of Figures : 0, Number of Tables : 2, Number of References : 19
Vol. 129, No. 2, Year 2013 (Cover Date: February 2013)
Journal Editor: Ben-Bassat I. (Qiryat-Ono)
ISSN: 0001-5792 (Print), eISSN: 1421-9662 (Online)
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