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VOLUME 2 , ISSUE 1 ( January-June, 2012 ) > List of Articles

ORIGINAL ARTICLE

Impact of Pentoxifylline and Vitamin E on Ribavirin-induced Hemolytic Anemia in Chronic Hepatitis C Patients: An Egyptian Survey

Mehdat Assem, M Yousri

Citation Information : Assem M, Yousri M. Impact of Pentoxifylline and Vitamin E on Ribavirin-induced Hemolytic Anemia in Chronic Hepatitis C Patients: An Egyptian Survey. Euroasian J Hepatogastroenterol 2012; 2 (1):35-40.

DOI: 10.5005/jp-journals-10018-1029

License: CC BY-NC 4.0

Published Online: 01-08-2018

Copyright Statement:  Copyright © 2012; The Author(s).


Abstract

Background: The present study aimed to elucidate the impact of combined pentoxifylline and high-dose vitamin E supplementation on Ribavirin (RBV)-induced hemolytic anemia in patients with chronic hepatitis C (CHC). Patients and methods: A total of 200 treatment-naïve chronic CHC patients were randomized into two groups to receive either the standard antiviral therapy and pentoxifylline (800 mg) and high-dose vitamin E (1000 IU) daily (combined group) or standard antiviral therapy and placebo (control group). They were followed-up to assess occurrence of anemia and virological responses respectively. Results: Dose modification of RBV due to anemia was significantly lower in combined group (8.5%) compared to control group (21.5%) (p < 0.05). Withdrawal from therapy due to severe anemia (Hb < 8.5 gm/dl) was recorded only in six (28.6%) patients of the control group. Both end of treatment response (ETR) and sustained virological response (SVR) were significantly higher in combined group compared to control (p < 0.05). Conclusion: Pentoxifylline and vitamin E can ameliorate RBVassociated hemolysis; improve compliance and virologic clearance, when combined with the standard antiviral therapy in patients with CHC.

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  1. Williams R. Global challenges in liver disease. Hepatology 2006;44:521-26
  2. Global epidemiology of hepatitis C virus infection. Lancet Infect Dis 2005;5:558-67
  3. Hepatitis C genotype 4: What we know and what we do not yet know? Hepatology 2008;47:1371-83. 40 JAYPEE Mehdat Assem, M Yousri 4. Ray SC, Arthur RR, Carella A, et al. Genetic epidemiology of hepatitis C virus throughout Egypt. J Infect Dis 2000;182: 698-707
  4. PEGASYS International Study Group. Peginterferon-alpha 2a and ribavirin combination therapy in chronic hepatitis C: A randomized study of treatment duration and ribavirin dose. Ann Intern Med 2004;140:346-55
  5. Haemolytic anaemia induced by ribavirin therapy in patients with chronic hepatitis C virus infection: Role of membrane oxidative damage. Hepatology 2000;31:997-1010
  6. Ribavirininduced anaemia: Mechanisms, risk factors and related targets for future research. Curr Med Chem 2006;13:3351-57
  7. Peginterferon alpha 2a and ribavirin combination therapy in chronic hepatitis C: A randomized study of treatment duration and ribavirin dose. Ann Intern Med 2004;140:346-55
  8. Peripheral arterial disease: Pathophysiology, risk factors, diagnosis, treatment and prevention. J Vasc Nurs 2009;27:26-30
  9. Effect of pentoxifylline on the evolution of diabetic nephropathy. Med Clin (Barc) 2009;132:772-78
  10. Effect of pentoxifylline on inflammatory burden, oxidative stress and platelet aggregability in hypertensive type 2 diabetes mellitus patients. Vascul Pharmacol 2007;47:118-24
  11. Beneficial effects of tumour necrosis factor-alpha inhibition by pentoxifylline on clinical, biochemical, and metabolic parameters of patients with non-alcoholic steatohepatitis. Am J Gastroenterol 2004; 99: 1946-52
  12. Pentoxifylline down regulates profibrogenic cytokines and procollagen I expression in rat secondary biliary fibrosis. Gut 2002;50:241-47
  13. Non-alcoholic steatohepatitis and insulin resistance: Interface between gastroenterologists and endocrinologists. Acta Clin Belg 2003;58:81-91
  14. Insulin resistance in patients with steatohepatitis. Hepatogastroenterology 2003;50:456-59
  15. (Accesse june 14, 2010, at: www. hcvadvocate.org/hepatitis/factsheets_pdf 17. Luca C, Grigore L, Vâþã A, et al. Adverse reactions of different treatments in chronic hepatitis C. Rev Med Chir Soc Med Nat Iasi 2009; 113:991-95
  16. Predictors of response to chronic hepatitis C treatment. Ann Hepatol 2010;9 Suppl:54-60
  17. High-dose vitamins E and C supplementation prevents ribavirin-induced haemolytic anaemia in patients with chronic hepatitis C. Hepatol Res 2007;37:317-24
  18. High-dose vitamin E supplementation does not diminish ribavirin-associated haemolysis in hepatitis C treatment with combination standard alpha-interferon and ribavirin. Aliment Pharmacol Ther. 2004;20:1189-93
  19. The effect of pentoxifylline on filterability of normal red blood cells and their adhesiveness to cultured endothelial cells. Eur J Clin Pharmacol 1985;29:55-59
  20. Treatment of homozygous sickle cell disease with pentoxifylline. J Natl Med Assoc 1999;91:466-70
  21. Effect of pentoxifylline on levels of pro-inflammatory cytokines during chronic hepatitis C. Scand J Immunol 2006;63:461-67
  22. Strategies for managing anaemia in hepatitis C patients undergoing antiviral therapy. Am J Gastroenterol 2007;102:880-89.
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