I. Marincu 1, L. Negruţiu 1, I. Iacobiciu 2, R. Neghina 2, Sorina Laitin 1, Adriana Maria Neghina 1
1 Department of Infectious Diseases, Victor Babeş University of Medicine and Pharmacy Timişoara, Romania
2 Department of Parasitology, Victor Babeş University of Medicine and Pharmacy Timişoara, Romania
Abstract
Introduction. Treatment with peg-interferon (Peg-IFN) and ribavirin in patients with chronic hepatitis C (CHC) represents current standard therapy, although it is accompanied by multiple side effects. Objectives. The present study aims at analysing the prevalence and etiology of acute bacterial infections in patients with CHC who are following peg-interferon and ribavirin combination therapy. Patients and methods. We have retrospectively investigated the medical records of 62 patients with CHC who were managed at the Hospital of Infectious Diseases in Timişoara, Romania. We have included in the study the patients who presented detectable HCV RNA, normal or increased alanine aminotransferase levels, histological rate ≥ 1, fibrosis and were aged ≤ 65 years. All patients were treated with Peg-IFN α-2a (Pegasys, Roche), 180 μg/week and ribavirin (Copegus, Roche, 1 tablet = 200 mg), 1000-1200 mg/day (1000 mg/day for patients under 75 kilos and 1200 mg/day for patients over 75 kilos) for 48 weeks. The patients have been evaluated monthly clinically and biologically and different explorations were carried out in selected cases in accordance to the disease management protocol. Results. In the study group, 22 (35.5%, male=10, female=12) patients with acute bacterial infections were diagnosed as follows: 5 patients with staphylococcal infections, 3 with urinary infections, 3 with acute bronchitis, 2 with bacterial pneumonia, 3 with acute sinusitis, 4 with acute tonsillitis and 2 with acute angiocholitis. The development of acute bacterial infections in our study group was associated with an advanced stage of liver fibrosis (F3-F4 – 16 patients), neutropenia (N-II – 11 patients), anemia (AII – 16 patients) and advanced thrombocytopenia (TII – 18 patients). Conclusions. The high prevalence (35.5%) of acute bacterial infections in patients with chronic hepatitis C treated with Peg-IFN and ribavirin requires a rigorous clinical, laboratory and therapeutic monitoring of the patients during this period.