HEPATITIS C

Objectives: To determine the frequency of thrombocytopenia and its manifestations in patients with Chronic Hepatitis C Virusinfection treated with interferon and ribavirin. Data Source: In door and out door patients. Design of Study: Case series. Setting and Periodof Study: Department of Medicine PNS Shifa Hospital Karachi, from 1s t August 2006 to 1s t July 2007. Materials and Methods: A Proformawas designed to enter the data of 100 patients fulfilling the inclusion criteria included in the study. Adult patients between the ages of 18 and50 years of both gender were selected. Presence of anti HCV antibodies, elevated serum alanine transaminase, a positive polymerase chainreaction for hepatitis C ribonucleic acid and compensated liver disease were prerequisites. All patients were treated with combination ofinterferon and ribavirin. Blood counts, alanine transaminase and prothrombin time were done at baseline and at 2,4 & 8 weeks intervals afterstarting interferon. A drop in platelets count below 100,000/cmm was taken as interferon induced thrombocytopenia. Results: In our studythrombocytopenia occurred in 11 % patients. Grade 3 thrombocytopenia (platelet counts < 50,000) occurred in 01 patient out of hundred in whichthere was severe gum bleeding and purpura so antiviral treatment was discontinued. Grade 2 thrombocytopenia (platelet counts between 50,000- 75,000) was observed in 03% patients but there were no bleeding episodes, 50% reduction dose was done in these patients. Grade 1thrombocytopenia (platelet counts between 75,000-100,000) was noticed in 07% patients but there were no bleeding manifestations and dosereduction was not done. Conclusion: Combination therapy is well tolerated, however, it can cause life threatening complications like bleedingepisodes in a few patients. Bleeding complications and manifestations as a result of thrombocytopenia are uncommon.