ABSTRACT
To determine the frequency and severity of leucopenia during antiviral treatment in patients with hepatitis C and the effectiveness of G-CSF [Granulocyte-Colony Stimulating Factor] in its management. An observational study. Shafi Clinic, Rawalpindi, from July 2005 to July 2007. Patients with Polymerase Chain Reaction [PCR] positive for Hepatitis C Virus-Ribonucleic Acid [HCV-RNA] by Enzyme Linked Immunosorbent Assay [ELISA] method were included in the study. Standard combination therapy was given to all i.e. interferon and ribavirin. Those with total leukocyte count [TLC] <4000/cmm were given injection Granulocyte-Colony Stimulating Factor [G-CSF] according to severity of leucopenia. Response to therapy was noted and dose titration was done accordingly. A total of 208 patients were enrolled in the study with 99 [48%] males and 109 [52%] females. Total leukocyte count [TLC] < 4000/cmm was observed in 78 [37.5%] cases. Conventional interferon induced leucopenia was seen in 60 out of 172 [35%] cases. Pegylated interferon induced leucopenia was seen in 18 out of 36 [50%] cases. Patients on Pegylated interferon had more severe leucopenia as compared to those on conventional interferon. Granulocyte-Colony Stimulating Factor [G-CSF] administration resulted in an increase in mean total leukocyte count from 2300 to 5200/cmm. No patient required antiviral dose reduction or discontinuation. Recombinant Granulocyte-Colony Stimulating Factor [G-CSF] administration tends to manage leucopenia, which is a common adverse effect of antiviral treatment for hepatitis C