Hepatitis C virus (HCV) infection is a major health problem throughout the World. Egypt
has the highest worldwide prevalence of HCV (10-20%). The combination of peginterferon
and ribavirin can achieve sustained virologic response in over 50% of those treated.
However, adherence to treatment is critical to maintain high rates of virologic clearance.
Unfortunately, peginterferon plus ribavirin therapy can be associated with side effects,
some of which may lead to dose reduction, premature discontinuation of the drug, and
subsequent treatment failure. is to detect and to manage the hematological side effects of
pegylated interferon/ribavirin therapy in chronic HCV in Egyptian patients. This study was
done in Sohag city on 500 Egyptian patients who are candidates for pegylated interferon/
ribavirin therapy for chronic HCV. All patients were treated with peginterferon alfa 2a (180
mcg /week) or peginterferon alfa 2b (1.5 mcg/kg weekly) subcutaneously plus oral ribavirin
in a dose ranging from 800-1200 mg/day for 48 weeks. Baseline pretreatment assessment
included quantitative HCV-PCR, liver and kidney functions, complete blood picture, T3
and T4 levels, abdominal ultrasonography, liver biopsy, fundus examination and ECG.
Liver functions and complete blood picture were done at the 4th , 12th, 24th, and 48thweeks.
HCV- PCR was followed up at the 12th, 24th, and 48thweeks.During the period ofour
study, 153 (30.6%) of the studied patients had decrease in hemoglobin level to 10 g/dl,
while severe anemia with hemoglobin level less than 8.5 g/dl was found in 33 (6.6%)
patients. Reduction of total leucocytic count to 2000 cells/mm3was found in49 (9.8%)patients, while severe neutropenia with neutrophils count less than 750 cells/mm3 wasfound in 12 (2.4%) patients. Asymptomatic thrombocytopenia with platelets count from 50000 to 150000/mm3
was found in 141 (28.2%) patients, whilesevere thrombocytopenia with platelets count less than 50000/mm3was found in 3 (0.6%) patients. the hematological
side effects of pegylated interferon and ribavirin are anemia, leucopenia, and
thrombocytopenia in 30.6%, 9.8% and 34% of the patients during the course of the
treatment. These side effects can be managed by dose reduction or stoppage and by
administration of erythropoietin and Granulocyte colony-stimulating factor (G-CSF)