Evaluation of Hematological Changes and Hepatic Enzyme Level Response to Therapy with PEG-IFN and Ribavirin in Chc Patiens; An Albanian Case Study
Hepatitis C is a major global illness. According to The World Health Organization has 130 to 150 million people with chronic hepatitis C virus infection (HCV), corresponding to 2-2.5% of the world's total population. Approximately 399 000 people die each year from hepatitis C, mostly from cirrhosis and hepatocellular carcinoma. In Albania, according a Public Health Institute study, the prevalence of active HCV (presence of HCV-RNA`s) recorded to different ages and gender groups show to be 71.1%. During last decade, a high rate of eradication and SVR has been achieved with the combination of Pegylated interferon (PEG-IFN) and Ribavirin (RBV). The purpose of the study was to evaluate the hematological parameters changes and levels of liver enzyme early during course of treatment in chronic hepatitis C (CHC) patients receiving antiviral treatment. A total of 30 patients diagnosed with CHC in Service of Gastro-hepatology, University Hospital Centre "Mother Tereza" and which were under treatment with Peg interferon alfa-2a and Ribavirin were included in this study Complete blood cells count , platelet counts and liver enzyme ALT, AST , is performed on each sample of blood at the time of initiation of treatment, 3 months and 6 months after treatment,The degree of change of all the measurements parameters was assessed by comparing the obtained results.The data were statistically analyzed by using descriptive statistics for Windows SPSS program, version 15. In order to calculate the correlation between the parameters, the data were divided in three subgroups according to times of examination ALT values after six months treatment showed a significant decline of 20.69 % (mean value 68.48 U/L, compare to 86.35 U/L before treatment). AST decline rate after six month treatment was 10.20 % (mean value 60.44 U/L compare to 67.31 U/L before treatment). Hematological parameters measured also showed a significant decline rate during treatment.,3 and 6 months after treatment .Tthere is a significant decrease in the percentage of "normal" subjects for these parameter, compared to the respective % at the beginning of the treatment . In this study it was proved that treatment with antiviral therapy Peg-IFN and Ribavirine is an important predictive factor for early normalization of hepatic enzyme ALT and AST.Hematological changes; Anemia, a consequence of Ribavirin's action and leukopenia associated with interferon-mediated thrombocytopenia by bone marrow blockage are more pronounced in the first 12 weeks of treatment. Within 8 weeks after its discontinuation, the three figurative elements of the blood are returned to the prescription values of the medication.
Keywords - AST, ALT, CHC, HCV, Peg interferon alfa-2a, Ribavirine,